Morphofunctional Improvement of the Facial Nerve and Muscles with Repair Using Heterologous Fibrin Biopolymer and Photobiomodulation.

Peripheral nerve injuries impair the patient's functional capacity, including those occurring in the facial nerve, which require effective medical treatment. Thus, we investigated the use of heterologous fibrin biopolymer (HFB) in the repair of the buccal branch of the facial nerve (BBFN) associated with photobiomodulation (PBM), using a low-level laser (LLLT), analyzing the effects on axons, muscles facials, and functional recovery. This experimental study used twenty-one rats randomly divided into three groups of seven animals, using the BBFN bilaterally (the left nerve was used for LLLT): Control group-normal and laser (CGn and CGl); Denervated group-normal and laser (DGn and DGl); Experimental Repair Group-normal and laser (ERGn and ERGl). The photobiomodulation protocol began in the immediate postoperative period and continued for 5 weeks with a weekly application. After 6 weeks of the experiment, the BBFN and the perioral muscles were collected. A significant difference (p < 0.05) was observed in nerve fiber diameter (7.10 ± 0.25 µm and 8.00 ± 0.36 µm, respectively) and axon diameter (3.31 ± 0.19 µm and 4.07 ± 0.27 µm, respectively) between ERGn and ERGl. In the area of muscle fibers, ERGl was similar to GC. In the functional analysis, the ERGn and the ERGI (4.38 ± 0.10) and the ERGI (4.56 ± 0.11) showed parameters of normality. We show that HFB and PBM had positive effects on the morphological and functional stimulation of the buccal branch of the facial nerve, being an alternative and favorable for the regeneration of severe injuries.

Eficácia da estimulação elétrica com corrente russa após neurorrafia término-lateral do nervo fibular comum: análise eletroneuromiográfica e de força muscular / Eficacia de la estimulación eléctrica con la corriente rusa tras la neurorrafia término-lateral del nervio fibular común: análisis electroneuromiográfico y de fuerza muscular muscular / Efficacy of electrical Russian current stimulation after end-to-side neurorrhaphy of the common fibular nerve: electroneuromyography and muscle strength analysis

RESUMO Lesões de nervos periféricos levam a perda funcional elevada no tecido muscular. Assim, muitas pesquisas têm investigado técnicas cirúrgicas, como neurorrafias, e recursos terapêuticos, como eletroestimulação, para melhorar a funcionalidade de um músculo reinervado após lesão periférica. Este estudo tem como objetivo investigar os efeitos da eletroestimulação com corrente russa (2.500Hz, 4ms, 10 seg. de contração por 20 seg. de relaxamento, modulação de 10Hz e 100 Hz) na recuperação funcional após secção e neurorrafia término-lateral do coto distal do nervo fibular comum à face lateral do nervo tibial em ratos. Foram utilizados 25 ratos Wistar, machos, com 80 dias de vida, fornecidos pelo Biotério Central da Universidade Sagrado Coração (Bauru, SP, Brasil). Os animais foram divididos aleatoriamente em cinco grupos: grupo-controle Inicial (GCI), grupo-controle final (GCF), grupo experimental não tratado (GENT), grupo neurorrafia término-lateral com estimulação russa (GNTLER) e grupo-controle desnervado (GCD). A corrente russa foi iniciada cinco dias após neurorrafia e aplicada no músculo tibial cranial do GNTLER, 3 vezes por semana, totalizando 36 sessões. A estimulação elétrica foi eficaz para aumentar a amplitude e diminuir a latência do músculo reinervado, além de aumentar a força muscular em comparação ao GCD. Diante disso, conclui-se que a eletroestimulação de média frequência (corrente russa) foi eficiente na recuperação funcional do músculo tibial cranial após neurorrafia término-lateral do nervo fibular comum.

RESUMEN Las lesiones de los nervios periféricos ocasionan una elevada pérdida funcional en el tejido muscular. De esta manera, en muchos estudios se han investigado técnicas quirúrgicas, como neurorrafias, y recursos terapéuticos, como la electroestimulación, para mejorar la funcionalidad del músculo reinervado tras una lesión periférica. El presente estudio tiene como objetivo investigar los efectos de la electroestimulación con corrente rusa (2.500Hz, 4ms, 10 seg. de contracción por 20 seg. de relajación, modulación de 10Hz y 100Hz) en la recuperación funcional tras la sección y neurorrafia término-lateral del muñón distal del nervio fibular común en la parte lateral del nervio tibial en ratas. Se utilizaron 25 ratas Wistar, machos, con 80 días de vida, proporcionadas por el Biotério Central de la Universidade do Sagrado Coração (Bauru, SP, Brasil). Se dividieron aleatoriamente los animales en cinco grupos: grupo de control inicial (GCI), grupo de control final (GCF), grupo experimental no tratado (GENT), grupo de neurorrafia término-lateral con estimulación rusa (GNTLER) y grupo de control denervado (GCD). La corriente rusa se inició cinco días tras la neurorrafia, siendo que la aplicó al músculo tibial craneal del GNTLER 3 veces a la semana, con un total de 36 sesiones. La estimulación eléctrica se mostró efectiva para aumentar la amplitud y disminuir la latencia del músculo reinervado, además de aumentar la fuerza muscular en comparación con el GCD. Por lo tanto, se concluye que la estimulación eléctrica de frecuencia media (corriente rusa) fue eficaz en la recuperación funcional del músculo tibial craneal tras la neurorrafia término-lateral del nervio fibular común.

ABSTRACT Peripheral nerve injury leads to a high functional loss of muscle tissue. Thus, many studies have investigated surgical techniques, such as neurorraphies, and therapeutic resources, such as electrical stimulation, to improve the functionality of reinnervated muscle after peripheral injury. This study aims to investigate the effects of electrical stimulation with Russian Current (2,500Hz, 4ms, 10:20 sec contraction/relaxation, modulated at 10Hz and 100Hz) in the functional recovery after section and end-to-side neurorrhaphy of the peroneal nerve distal stump common to the lateral face of the tibial nerve in rats. In this study, 25 male Wistar rats with 80 days of life were used, provided by the Universidade Sagrado Coração (USC), Bauru, SP, Brazil. The animals were randomly divided into five groups: Initial Control Group (ICG), Final Control Group (FCG), Untreated Experimental Group (UEG), End-to-Side Neurorrhaphy with Russian Stimulation Group (ENRSG), and Denervated Control Group (DCG). The Russian Current was started 5 days after neurorrhaphy and applied to the cranial tibial muscle of the ENRSG, 3 times a week, totaling 36 sessions. We observed that the electrical stimulation with Russian Current (ENRSG) was effective to increase amplitude (mV) and to decrease the latency (ms) of the reinnervated muscle, besides increasing the muscle strength when compared with the denervated control group. Therefore, we concluded that the average frequency electrical stimulation (Russian current) was efficient in the functional recovery of the cranial tibial muscle after the end-lateral neurorrhaphy of the common fibular nerve.

Fibrin Sealant Derived from Human Plasma as a Scaffold for Bone Grafts Associated with Photobiomodulation Therapy.

Fibrin sealants derived from human blood can be used in tissue engineering to assist in the repair of bone defects. The objective of this study was to evaluate the support system formed by a xenograft fibrin sealant associated with photobiomodulation therapy of critical defects in rat calvaria. Thirty-six rats were divided into four groups: BC (n = 8), defect filled with blood clot; FSB (n = 10), filled with fibrin sealant and xenograft; BCPBMT (n = 8), blood clot and photobiomodulation; FSBPBMT (n = 10), fibrin sealant, xenograft, and photobiomodulation. The animals were killed after 14 and 42 days. In the histological and microtomographic analysis, new bone formation was observed in all groups, limited to the defect margins, and without complete wound closure. In the FSB group, bone formation increased between periods (4.3 ± 0.46 to 6.01 ± 0.32), yet with lower volume density when compared to the FSBPBMT (5.6 ± 0.45 to 10.64 ± 0.97) group. It was concluded that the support system formed by the xenograft fibrin sealant associated with the photobiomodulation therapy protocol had a positive effect on the bone repair process.

Stimulation of morphofunctional repair of the facial nerve with photobiomodulation, using the end-to-side technique or a new heterologous fibrin sealant.

This research evaluated the influence of Photobiomodulation Therapy (PBMT) on lesions of the facial nerve repaired with the end-to-side technique or coaptation with a new heterologous fibrin sealant. Thirty-two Wistar rats were separated into 5 groups: Control group (CG), where the buccal branch of the facial nerve was collected; Experimental Suture Group (ESG) and Experimental Fibrin Group (EFG), in which the buccal branch was end-to-side sutured to the zygomatic branch on the right side of the face or coaptated with fibrin sealant on the left side; Experimental Suture Laser Group (ESLG) and Experimental Fibrin Laser Group (EFLG), in which the same procedures were performed as the ESG and EFG, associated with PBMT (wavelength of 830nm, energy density 6.2J/cm2, power output 30mW, beam area of 0.116cm2, power density 0.26W/cm2, total energy per session 2.16J, cumulative dose of 34.56J). The laser was applied for 24s/site at 3 points on the skin's surface, for a total application time of 72s, performed immediately after surgery and 3 times a week for 5weeks. A statistically significant difference was observed in the fiber nerve area between the EFG and EFLG (57.49±3.13 and 62.52±3.56µm2, respectively). For the area of the axon, fiber diameter, axon diameter, myelin sheath area and myelin sheath thickness no statistically significant differences were found (p<0.05). The functional recovery of whisker movement occurred faster in the ESLG and EFLG, which were associated with PBMT, with results closer to the CG. Therefore, PBMT accelerated morphological and functional nerve repair in both techniques.

Efficacy of Laser Photobiomodulation on Morphological and Functional Repair of the Facial Nerve.

OBJECTIVE: Evaluate the efficacy of low-level laser therapy (LLLT) on qualitative, quantitative, and functional aspects in the facial nerve regeneration process. MATERIALS AND METHODS: Forty-two male Wistar rats were used, randomly divided into a control group (CG; n = 10), in which the facial nerve without lesion was collected, and four experimental groups: (1) suture experimental group (SEG) and (2) fibrin experimental group (FEG), consisting of 16 animals in which the buccal branch of the facial nerve was sectioned on both sides of the face; an end-to-end epineural suture was performed on the right side, and a fibrin sealant was used on the left side for coaptation of the stumps; and (3) laser suture experimental group (LSEG) and (4) laser fibrin experimental group (LFEG), consisting of 16 animals that underwent the same surgical procedures as SEG and FEG with the addition of laser application at three different points along the surgical site (pulsed laser of 830 nm wavelength, optical output power of 30 mW, power density of 0.2586 W/cm2, energy density of 6.2 J/cm2, beam area of 0.116 cm2, exposure time of 24 sec per point, total energy per session of 2.16 J, and cumulative dose of 34.56 J). The animals were submitted to functional analysis (subjective observation of whisker movement) and the data obtained were compared using Fisher's exact test. Euthanasia was performed at 5 and 10 weeks postoperative. The total number and density of regenerated axons were analyzed using the unpaired t-test (p < 0.05). RESULTS: Laser therapy resulted in a significant increase in the number and density of regenerated axons. The LSEG and LFEG presented better scores in functional analysis in comparison with the SEG and FEG. CONCLUSIONS: LLLT enhanced axonal regeneration and accelerated functional recovery of the whiskers, and both repair techniques allowed the growth of axons.

Electrical stimulation attenuates morphological alterations and prevents atrophy of the denervated cranial tibial muscle / Eletroestimulação atenua alterações morfológicas e previne atrofia do músculo tibial cranial desnervado

ABSTRACT Objective To investigate if electrical stimulation through Russian current is able to maintain morphology of the cranial tibial muscle of experimentally denervated rats. Methods Thirty-six Wistar rats were divided into four groups: the Initial Control Group, Final Control Group, Experimental Denervated and Treated Group, Experimental Denervated Group. The electrostimulation was performed with a protocol of Russian current applied three times per week, for 45 days. At the end, the animals were euthanized and histological and morphometric analyses were performed. Data were submitted to statistical analysis with a significance level of p<0.05. Results The Experimental Denervated Group and the Experimental Denervated and Treated Group had cross-sectional area of smaller fiber compared to the Final Control Group. However, there was significant difference between the Experimental Denervated Group and Experimental Denervated and Treated Group, showing that electrical stimulation minimized muscle atrophy. The Experimental Denervated and Treated Group and Initial Control Group showed similar results. Conclusion Electrical stimulation through Russian current acted favorably in maintaining morphology of the cranial tibial muscle that was experimentally denervated, minimizing muscle atrophy.

RESUMO Objetivo Investigar se a estimulação elétrica pela corrente russa é capaz de manter a morfologia do músculo tibial cranial de ratos desnervados experimentalmente. Métodos Foram utilizados 36 ratos Wistar, distribuídos em quatro grupos: Grupo Controle Inicial, Grupo Controle Final, Grupo Experimental Desnervado Tratado, Grupo Experimental Desnervado. A eletroestimulação foi realizada com um protocolo de corrente russa aplicada três vezes por semanas, durante 45 dias. Ao final, os animais foram eutanasiados e, em seguida, foram realizadas as análises histológica e morfométrica. Os dados foram submetidos à análise estatística, com nível de significância de p<0,05. Resultados Os Grupos Experimental Desnervado e o Grupo Experimental Desnervado Tratado apresentaram área de secção transversal da fibra menor quando comparados ao Grupo Controle Final. Entretanto, constatou-se diferença significativa entre o Grupo Experimental Desnervado e o Grupo Experimental Desnervado Tratado, mostrando que a estimulação elétrica minimizou atrofia muscular. Ainda, observou-se que o Grupo Experimental Desnervado Tratado apresentou resultados semelhantes ao Grupo Controle Inicial. Conclusão A estimulação elétrica por meio da corrente russa foi favorável na manutenção da morfologia do músculo tibial cranial desnervado experimentalmente, minimizando a atrofia muscular.

Effect of low-level laser therapy (LLLT) on peripheral nerve regeneration using fibrin glue derived from snake venom.

OBJECTIVES: The purpose of this study was to assess whether the adhesive permits the collateral repair of axons originating from a vagus nerve to the interior of a sural nerve graft, and whether low-level laser therapy (LLLT) assists in the regeneration process. MATERIALS AND METHODS: Study sample consisted of 32 rats randomly separated into three groups: Control Group (CG; n=8), from which the intact sural nerve was collected; Experimental Group (EG; n=12), in which one of the ends of the sural nerve graft was coapted to the vagus nerve using the fibrin glue; and Experimental Group Laser (EGL; n=12), in which the animals underwent the same procedures as those in EG with the addition of LLLT. Ten weeks after surgery, the animals were euthanized. Morphological analysis by means of optical and electron microscopy, and morphometry of the regenerated fibers were employed to evaluate the results. RESULTS: Collateral regeneration of axons was observed from the vagus nerve to the interior of the autologous graft in EG and EGL, and in CG all dimensions measured were greater and presented a significant difference in relation to EG and EGL, except for the area and thickness of the myelin sheath, that showed significant difference only in relation to the EG. CONCLUSIONS: The present study demonstrated that the fibrin glue makes axonal regeneration feasible and is an efficient method to recover injured peripheral nerves, and the use of low-level laser therapy enhances nerve regeneration.

O efeito da laserterapia de baixa potência em aspectos histológicos em um modelo experimental de lesão muscular por estiramento controlado em ratos / The effect of low-level laser therapy in histological aspects in a model of experimental muscle injury in rat controlled muscle strain

Estiramento muscular e outras desordens musculoesqueléticas são as principais causas que desabilitam atletas e praticantes de atividades físicas. Seu tratamento inclui AINES que desencadeiam vários efeitos adversos. Objetivo: o objetivo do estudo foi avaliar o efeito dos tratamentos com Laserterapia de Baixa Potência e do anti-inflamatório diclofenaco, tanto individualmente quanto combinados (laser + aplicação por vias tópica ou intramuscular de diclofenaco) em aspectos histológicos no modelo experimental de lesão muscular por estiramento controlado em ratos. Materiais e Métodos: a lesão por estiramento foi induzida, por sobre carga, no músculo tibial anterior de ratos (n=6). O grupo controle não recebeu tratamento, grupos lesados receberam um único tratamento com diclofenaco através das vias tópica ou intramuscular, irradiação com laser (3 J, 830 nm, 100 mW) ou os dois tratamentos conjuntamente, laser e diclofenaco, totalizando seis grupos experimentais. Os tratamentos foram realizados 1 hora após a lesão. O músculo tibial foi removido para análise histológica, três horas após a indução da lesão e também seis horas após indução. Resultados e discussão: a avaliação histológica demonstrou uma melhor organização estrutural do tecido muscular, células bem delineadas e menor quantidade de fibras fragmentadas e menor descontinuidade de acidofilia nos grupos tratados com laser e diclofenaco, nas duas vias de aplicação, tanto no período de 3 horas quanto no de 6 horas após a lesão. Conclusão: a irradiação do laser de baixa potência conjuntamente ao diclofenaco tópico e intramuscular melhorou aspectos histológicos do tecido muscular, após lesão por estiramento, na fase aguda quando comparado com os demais tratamentos...

Muscle stretch and other musculoskeletal disorders are the main causes that disable athletes and fitness enthusiasts. His treatment includes NAIDs that trigger various adverse effects. Objective: the objective of the study the effect of treatments with Low Power Laser (LPL) Therapy and the anti-inflammatory diclofenac, both individually and combined (LPL + intramuscular or topical application of diclofenac pathways) in histological aspects in an experimental model was to evaluate muscle injury in rats controlled stretch. Materials and Methods: the injury was induced by muscle stretch, overload, the tibialis anterior muscle of rats (n = 6). The control group received no treatment, injured groups received a single treatment with diclofenac through the anti-inflammatory topical or intramuscular (AT and AIM), irradiation with LPL (3 J 830 nm, 100 mW), or the two treatments together, LPL and diclofenac (LPL/LPL or AT/AIM), totaling six experimental groups. All treatments were performed 1 hour after the injury. The right anterior tibial muscle was removed for histological analysis, within 3 hours after induction of the lesion and also 12 hours after induction. Results and discussion: histological evaluation in this study showed a better estructural organization of muscle tissue, cells and less well defined amount of fragmented fibers in the group treated with LPL and LPL AT + 3J 3J + AIM in both the 3-hour period and in 6 hours following injury. Conclusion: treatment with LPL jointly to the topic and intramuscular diclofenac improved the histological aspects of muscle tissue after stretch injury in the acute phase compared with the other treatments...

Ozone Therapy in Dentistry: A Systematic Review / Ozonoterapia en Odontología: Una Revisión Sistemática

The purpose of this systematic review was to verify the literature available regarding the effectiveness and the biological effects of ozone therapy in periodontics, orthodontics and dental implants. Studies were searched in September 2012. Analyzed sources included the databases PubMed, Lilacs and SciELO, through a combination of key words, dental implants, periodontics, orthodontics, therapeutics. Studies between 2002 and 2012 were included. In vitro and in vivo studies English and Spanish language publications, excluding posters, letters to the editors and conferences. In Vitro and in Vivo studies showed the inactivation of the major periodontal pathogens by ozone. There were divergent results and lack of evidence for the activity of ozone on adhesion of orthodontic brackets, in implantology and orthodontics. Ozone could be considered as a promissory alternative therapy in dentistry. However, well-designed studies are needed to assess the application of ozone in order to evaluate its clinical effectiveness in the field of dentistry.

El objetivo de esta revisión sistemática fue verificar la literatura disponible relacionada a la efectividad y efectos biológicos de la ozonoterapia en periodoncia, ortodoncia e implantes dentales. Se realizó una revisión sistemática en septiembre del 2012 en las bases de datos PubMed, LILACS and SciELO por medio de la combinación de las palabras clave dental implants, periodontics, orthodontics, therapeutics. Se evaluaron los artículos publicados entre los años 2002 y 2012. Fueron incluidos estudios In vitro e in vivo y publicaciones en Inglés y Español, excluyendo pósters, carta al editor y conferencias. Estudios in vitro e in vivo mostraron inactivación de los principales patógenos periodontais con el uso del ozono. Hubo resultados contradictorios y falta de evidencia sobre la acción del ozono en la adhesión de los brackets ortodónticos, así como también en la osteointegración de los implantes dentales. El ozono puede ser considerado como una terapia alternativa promisoria en la Odontología. Sin embargo, es necesaria la realización de estudios bien diseñados para, de ese modo, evaluar la aplicación del ozono y su efectividad clínica en el campo de la Odontología.

Efeito da corrente alternada simétrica sinusoidal na musculatura estriada esquelética desnervada experimentalmente / Effect of sinusoidal alternated current in experimentally denerved skeletal striated muscle

Introdução: A utilização da estimulação elétrica (EE) no tratamento de músculos desnervados tem sido muito estudada, pois auxilia na reinervação tardia e minimiza a atrofia muscular. Objetivo: Neste estudo, avaliamos a EE através da corrente alternada simétrica sinusoidal na manutenção dos aspectos morfológicos dos músculos Extensor longo dos dedos (EDL) e Sóleo desnervados experimentalmente. Método: Quarenta ratos da linhagem wistar foram divididos em quatro grupos experimentais (n=10): Em grupo controle inicial (GCI), controle Final (GCF), desnervado (GD), e em desnervado e estimulado (GDE). A aplicação EE no músculo EDL e sóleo teve início 48 horas após a lesão nervosa, sendo aplicada três vezes por semana durante quarenta e cinco dias. Cortes transversais foram corados com HE para a mensuração da morfometria das fibras musculares. Para a análise estatística foi utilizado a análise de variância (one-way - ANOVA) seguido pelo teste de tukey (p < 0,05). Resultados: Os animais do grupo D e DE apresentaram uma diminuição da área de secção transversal (AST) quando comparadas ao CF. Porém o grupo DE minimizou a atrofia muscular, pois houve diferença estatisticamente significativa quando comparado ao D, tanto no músculo EDL quanto no sóleo. Conclusão: A EE foi eficiente na manutenção dos aspectos morfológicos dos músculos EDL e sóleo, minimizando a atrofia muscular. Podendo ser um tratamento útil para as lesões nervosas periféricas.

Introduction: the use of electrical stimulation (ES) in the treatment of denervated muscles has been studied as it assists in the late reinnervation and minimizes muscle atrophy. Purpose: this study assessed the ES through the symmetric sinusoidal alternating current in the maintenance of the morphological aspects of the experimentally denervated Extensor digitorum longus (EDL) and Soleus muscles. Method: Forty Wister rats were divided into four experimental groups (n = 10): initial control group ( ICG), final control group (FCG), denervated group (DG) and denervated and stimulated group (DSG). ES was first applied in the soleus and EDL muscle 48 hours after nerve injury, the applications took place three times per week for forty-five days. Cross-sections were stained with HE to perform the morphometric analysis of the muscle fibers. We used the analysis of variance (one-way - ANOVA) followed by the Tukey test (p < 0.05) for statistical analysis. Results: the animals belonging to group D and DE showed a decrease in the crosssectional area (CSA) when compared to FCG. However, the group DE had muscular atrophy minimized, as there was a statistically significant difference when compared to D, both for EDL and soleus muscles. Conclusion: the ES was effective in maintaining the morphological aspects of the EDL and soleus muscles, minimizing muscle atrophy. This may be a useful treatment for the peripheral nerve injuries.

Anatomia e avaliação funcional do músculo frontal: estudos dos padrões de contração / Anatomy and functional evaluation of the frontalis muscle: study on contraction's patterns

Introdução: na face estão inseridos numerosos músculos, artérias, glândulas, veias e nervos. O arranjo anatômico do músculo frontal permite uma grande mobilidade à região frontal, sendo, pois considerado o músculo mimético do couro cabeludo. A interpretação de cada uma das emoções apresenta diferenças substanciais: o temor, conforme esperado, é detectado quase que exclusivamente na parte superior do rosto. Objetivo: classificar os padrões de contração do músculo frontal de estudantes do curso de fisioterapia de uma Universidade da cidade de Bauru, estado de São Paulo. Material e Método: Trata-se de uma análise retrospectiva de fotografias de 105 sujeitos. Resultados: obteve-se uma imagem da face do sujeito com o músculo frontal em repouso e a segunda durante a contração máxima do músculo frontal. Quatro padrões foram identificados por quatro examinadores em: total, medial, lateral, hipocinesia. O padrão total foi observado em 32,4 por cento examinador A, 36,1 por cento examinadores B e C, 30,4 por cento examinador D. O padrão medial foi de 25,7 por cento examinador A, 23,8 por cento examinador B, 27,6 por cento examinador C, 29,5 por cento examinador D. O padrão lateral foi de 11,4 por cento examinadores A e D, 16,1 por cento examinador B e 14,2 por cento examinador C. O padrão hipocinesia foi de 30,5 por cento examinador A, 23,8 por cento examinador B, 21,9 por cento examinador C e 28,5 por cento examinador D. Conclusão: conclui-se que o conhecimento dos vários padrões de contração do músculo frontal, permite um planejamento e intervenção fisioterapêutica mais eficiente e preciso.

Introduction: numerous muscles, arteries, small glands, blood vessels and nerves are inserted in the face. The anatomical arrangement of the frontalis muscle allows vast mobility to the frontal region, and is therefore considered the mimetic muscle of the scalp. The interpretation of each of the emotions shows essential differences: the fear, as expected, is detected almost exclusively in the upper face. Objective: classify the patterns of frontalis muscle contractions in students of physiotherapy in a University, located in Bauru, state of São Paulo, Brazil. Material and Method: this is a retrospective analysis of pictures taken from 105 subjects. Results: The first picture of the subject's face was taken with the frontalis muscle at rest and the second one, in maximal contraction of the frontalis muscle. Four patterns were identified by four examinators: total, medial, lateral, hypokinesia. The total pattern was observed in 32.4 per cent, examinator A; 36.1 per cent by examinators B and C; and 30.4 per cent, examinator D. The medial pattern was observed in 25.7 per cent, examinator A; 23.8 per cent examinator B; 27.6 per cent , examinator C and 29.5 per cent, examinator D. The lateral pattern was observed in 11,4 per cent, examinators A and D; 16,1 per cent, examinator B; and 14,2 per cent examinator C. The hypokinesia pattern was observed in 30,5 per cent, examinator A; 23,8 per cent, examinator B; 21,9 per cent examinator C; and 28,5 per cent, examinator D. Conclusion: we conclude that the knowledge of the several patterns of frontalis muscle contractions, allows a more efficient and accurate planning and interventions in physioytherapy.