Análise da eficácia do agulhamento seco e da massagem facial no tratamento de disfunções temporomandibulares com base em relato de caso clínico / Analysis of the effectiveness of dry needing and facial massage in the treatment of temporomandibular disorders based on a clinical case report

O objetivo do presente trabalho é apresentar um relato de caso de Disfunção Temporomandibular (DTM) dolorosa de origem muscular, tratado por meio de Agulhamento Seco (AS) e Massagem Facial (MF). Paciente do sexo feminino, M.R.B.A., de 47 anos, com diagnóstico de dor miofascial com referência do lado esquerdo e deslocamento de disco com redução do lado esquerdo, de acordo com os Critérios de Diagnóstico e Tratamento das Disfunções Temporomandibulares (DC/TMD). A paciente foi submetida a cinco sessões de AS e MF, executadas por fisioterapeuta experiente. Na primeira consulta, foi realizada a anamnese e exame físico para a obtenção de informações sobre qualidade, frequência, duração e intensidade da dor, bem como fatores de melhora, fatores de piora, fatores acompanhantes, fatores desencadeantes e tratamentos prévios. A intensidade da dor foi avaliada através de escala visual analógica e as intervenções com agulhamento seco foram iniciadas a partir da segunda consulta. Ao final das sessões, a paciente foi orientada quanto à continuidade de exercícios de relaxamento muscular e ao uso de placa interoclusal. Com base na escala adotada, o quadro doloroso geral da paciente teve evolução positiva de 6 a 0 após o tratamento, com destaque observado em seus pontos gatilhos de 10 e 8 para 6 e 3, para os lados esquerdo e direito respectivamente. Concluise que, após a aplicação da terapia proposta, a paciente obteve melhora com redução significativa em sua sintomatologia dolorosa em ambos os lados(AU)

The objective of this work is to present a case report of Dysfunction Painful temporomandibular joint (DTM) of muscular origin, treated with needling Dry (AS) and Facial Massage (MF). Female patient, M.R.B.A., 47 years old, with a diagnosis of myofascial pain with reference on the left side and displacement of disc with reduction on the left side, according to the Diagnostic and Treatment of Temporomandibular Disorders (DC/TMD). The patient underwent five sessions of AS and MF, performed by an experienced physiotherapist. At the first consultation, anamnesis and physical examination were carried out to obtain information on quality, frequency, duration and intensity of pain, as well as improvement factors, worsening factors, accompanying factors, triggering factors and previous treatments. The intensity of pain was assessed using a visual analogue scale and interventions with needling dry were started from the second consultation. At the end of the sessions, the patient was guided regarding the continuation of muscle relaxation exercises and the use of interocclusal splint. Based on the adopted scale, the patient's general painful condition was positive evolution of 6 to 0 after treatment, with emphasis on its points triggers from 10 and 8 to 6 and 3, for the left and right sides respectively. It is concluded that, after applying the proposed therapy, the patient improved with reduction significant in its painful symptoms on both sides

Toxicity and Anti-Inflammatory Effects of Agave sisalana Extract Derived from Agroindustrial Residue.

BACKGROUND: In several countries, the leaf juice of Agave sisalana (also known as sisal) is widely used topically, especially as an antiseptic, and orally for the treatment of different pathologies. However, in Brazil, which is the largest producer of Agave sisalana, its residue, which represents the majority of its weight, has been thrown away. For this reason, the determination of the pharmacological and toxicological potentials of sisal residue and its possible therapeutic use is seen as a way to contribute to the sustainable development and social promotion of the largest producer of sisal in Brazil, the interior of Bahia State, which is among the poorest areas in the country. Given the scarcity of available scientific studies on the pharmacological and toxicological properties of sisal residue juice, this study aimed to promote the acid hydrolysis of this juice to potentiate the anti-inflammatory effect already described in the literature. Furthermore, it aimed to evaluate the toxicological profile of the hydrolyzed extract (EAH) and to determine its acute toxicity, as well as its side effects on the reproductive aspects of rats. METHOD: The anti-inflammatory effect of EAH was evaluated in vitro using the induction of hemolysis by hypotonic solution and in vivo in rats using the carrageenan-induced paw edema test and the xylene-induced ear edema test. The acute toxicity, resulting from a single-dose administration, was investigated for some manifestation of toxic symptoms related to motor control and consciousness in rats. At a concentration of 100 mg/kg, by repeated doses, the reproductive toxicity effects of EAH in rats were assessed. RESULTS: In vitro anti-inflammatory activity was positive using the human red blood cell membrane stabilization method. In both in vivo tests used to assess the anti-inflammatory activity, EAH (at three doses) significantly inhibited edema when compared to the control group. At a dose of 50 mg/kg, EAH exhibited a greater effect than indomethacin, a nonsteroidal anti-inflammatory drug with known activity. In vivo toxicological studies have shown that EAH does not present toxic effects when administered orally in a single dose, up to 1000 mg/kg. Finally, EAH promoted a gonadotoxic effect and increased the embryonic mortality rate after implantation. CONCLUSIONS: It is suggested that the anti-edematogenic effect of the acid hydrolysis extract from sisal juice is due to the high concentration of steroidal sapogenins. Therefore, this extract can be considered a potential new anti-inflammatory or even an important sapogenin source for the development of steroidal glucocorticoids. However, further studies are needed to elucidate the chemical composition of sisal juice. Regarding toxicology studies, EAH did not show cytotoxic and clastogenic potentials, but it presented a powerful reproductive toxic effect in rats.

Relationship of excessive daytime sleepiness with bruxism, depression, anxiety, stress, and sex in odontology students - A cross sectional study.

Background: To verify if there is a correlation of excessive daytime sleepiness (EDS) with bruxism, depression, anxiety, stress, and sex in odontology students. Material and Methods: Four hundred dental students were selected. Students included in the study were those that were healthy, over 18 years old, and with similar weekly academic activities. Students excluded were those with temporomandibular disfunction, a high possibility of possessing obstructive sleep apnea and illnesses that cause EDS; along with smokers, users of illicit drugs, users of psychiatric medication, and those that abuse the consumption of alcohol. After the application of these criteria, 128 students were included in this study. EDS, bruxism, depression, anxiety, and stress were evaluated by the Epworth Sleepiness Scale, the Pintado et al. questionnaire, Beck Depression Inventory, Beck Anxiety Inventory, and the LIPP Adult Stress Symptom Inventory. Afterwards, the Spearman test (p< 0.05) was applied. Results: A high probability of EDS was present in 33.6% of the students. There was a positive correlation of EDS with females (Rank Correlation= 0.209; p= 0.018) and depression (Rank Correlation= 0.174; p= 0.049); between females and stress (Rank Correlation= 0.199; p= 0.024), and between females and anxiety (Rank Correlation= 0.178; p= 0.045). There was a positive correlation of bruxism with anxiety (Rank Correlation= 0.255; p= 0.004) and stress (Rank Correlation= 0.201; p= 0.023). There was no correlation of EDS with bruxism (p= 0.354), stress (p= 0.277), or anxiety (p= 0.114). There was no correlation of bruxism with females (p= 0.082) or depression (p= 0.362). Conclusions: A high probability of EDS was present in 33.6% of dentistry students, and there was a positive correlation of EDS with females and depression. Key words:Bruxism, depression, anxiety, stress, disorders of excessive somnolence, dentistry.

Relationship of bruxism with oral health-related quality of life and facial muscle pain in dentate individuals.

Background: To determine whether there is a correlation of bruxism (sleep, daytime, or both) with oral health-related quality of life and facial pain of muscular origin in dentate individuals. Material and Methods: Seventy-four dentate patients (complete dentition) were included in this study. These individuals had pain in the facial muscles due to temporomandibular disorder (TMD). Smokers; and those with obstructive sleep apnea, TMD of joint origin associated or not with pain, malocclusion, and cancer; and users of illicit drugs, psychiatric medications, and alcohol were excluded. Obstructive sleep apnea, bruxism (of sleep and/or daytime), facial muscle pain, and oral health-related quality of life were assessed by the following questionnaires: Berlin Questionnaire, Pintado et al. questionnaire, VAS (Visual Analog Scale) facial muscle pain questionnaire, and Oral Health Impact Profile - 14. Four groups were created: 1) no bruxism; 2) sleep bruxism; 3) daytime bruxism; and 4) sleep and daytime bruxism. Spearman's correlation test was applied to verify if there was a correlation between the collected data. P values less than 0.05 were considered statistically significant. Results: There was a positive correlation of daytime bruxism with mean pain in the last 3 months (P<0.05) and the worst pain experienced in the last 3 months (P<0.05). Conclusions: Bruxism (sleep, daytime, or both) showed a positive correlation with lower oral health-related quality of life (P<0.05). Key words:Bruxism, facial pain, temporomandibular joint disorders, surveys and questionnaires, health-related quality of life.

Antagonistic effect of isolated and commercially available probiotics on the growth of Candida albicans on acrylic resin denture surfaces.

STATEMENT OF PROBLEM: Biofilms can be retained on dental prostheses leading to the development of infections. The indiscriminate use of antifungal drugs can result in the development of microorganisms that are resistant to these antimicrobial agents. Whether probiotics are a suitable alternative for reducing the prevalence of oral candidiasis is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the influence of 6 different live strains of probiotics and 2 commercially available probiotic supplements used for inhibiting the growth of Candida albicans biofilm in heat-polymerized acrylic resin denture base material and to determine whether biofilm byproducts modify the surface of specimens. MATERIAL AND METHODS: Biofilms of C. albicans were formed on acrylic resin specimens in the presence of probiotics and quantified by colony-forming units (CFUs), and the surface roughness (Ra) of the specimens was assessed before and after the formation of biofilms. The CFU and roughness data were analyzed by analysis of variance and the Tukey HSD test (α=.05). RESULTS: A significant decrease in the number (CFU/mL) of C. albicans cells was found when they were cultured with 4 probiotics: B. lactis (P=.045), B. longum (P<.001), L. casei (P<.001), and L. helveticus (P<.001) and with the commercially available probiotic Prolive (P=.05). The Ra of specimens decreased after exposure to different microbial biofilms (P≤.05) except in 3 experimental groups. CONCLUSIONS: In general, the tested probiotics had an antagonistic effect on the growth of C. albicans, and the surface of acrylic resin was altered after exposure to biofilm byproducts.

Novos materiais livres de metal para confecção de próteses monolíticas em sistema CAD/CAM / New metal-free materials for making monolithic prostheses in CAD/CAM system

A busca por naturalidade dos procedimentos restauradores em reabilitação oral tem contribuído para o desenvolvimento de vários tipos de materiais livres de metal ("metal free"). A confecção de próteses com estes sistemas totalmente puros, mostra-se como excelente alternativa restauradora, com potencial estético superior às próteses metalocerâmicas. É indiscutível que a tecnologia CAD/CAM (Computer-aided design/ Computer-aided manufacturing) vem se tornando realidade nos consultórios e laboratórios de Prótese Dentária de todo o mundo. Esta tecnologia possibilita o uso de cerâmicas e polímeros na fabricação de próteses, com qualidade e resistência mecânica satisfatórias, padronizando os processos, reduzindo custos e tempo clínico-laboratorial. A grande diversidade destes novos materiais restauradores livres de metal, com suas distintas propriedades estéticas e mecânicas, faz com que seja necessária uma seleção racional desses materiais, a fim de se alcançar a longevidade desejada do tratamento protético reabilitador. Dentre estes materiais, destacam-se as cerâmicas vítreas, as zircônias monolíticas, as cerâmicas infiltradas por polímeros e as resinas nanocerâmicas. O objetivo do trabalho foi avaliar os dados mais relevantes e atuais sobre as propriedades destes novos materiais, os sistemas disponíveis, suas indicações, limitações e seu uso associado com a tecnologia CAD/CAM. Esta revisão consistiu em uma pesquisa eletrônica da literatura publicada nos últimos 15 anos, nas bases de dados: Medline/Pubmed, Embase, Scielo, Bireme, Lilacs e BBO, utilizando-se os seguintes descritores do MESH: [CADCAM AND restorative materials AND monolitic] OR [Monolitic CAD-CAM restorative materials]. Concluiu-se que os materiais monolíticos obtidos pelo sistema CAD/CAM foram desenvolvidos para oferecer uma melhor adaptação e durabilidade das peças, com ótimas taxas de sobrevida e redução de tempo clínico e laboratorial, oferecendo ao paciente conforto, sessões clínicas mais curtas e restaurações de qualidade superior aos sistemas convencionais. Todos os materiais citados nesta revisão apresentaram vantagens e desvantagens, cabendo ao profissional selecionar o melhor material para cada situação clínica em específico, levando em conta os prós e contras de cada um(AU)

The naturalness of restorative procedures in oral rehabilitation has contributed to the development of various types of metal-free materials ("metal free"). The manufacture of prostheses with these totally pure systems is shown to be an excellent restorative alternative, with an aesthetic potential superior to metal-ceramic prostheses. It is indisputable that CAD/ CAM (Computer-aided design/Computer-aided manufacturing) technology is becoming a reality in dental practices and laboratories around the world. This possibility of manufacturing ceramic materials and polymers in strength manufacturing, with strength technology, manufacturing processes, standardizing quality clinical time, higher cost and clinical time. These new aesthetic properties of metal, these dif ferences with aesthetic and mechanical characteristics, these differences are necessary for a rational selection of materials with a choice of rehabilitative prosthetic treatment. Among these materials, they stand out as glass ceramics, as monolithic zirconia, as polymer-infiltrated ceramics and as nanoceramic resins. The purpose of working with your materials, and their associated use with CAD/CAM technology. This review consists of an electronic search of the literature published in the last 15 years, in the following databases: Medline/ Pubmed, Embase, Scielo, Bireme, Lilacs and BBO, using the following MESH descriptors: [CAD-CAM AND restorative materials AND monolithic] OR [CADCAM monolithic restorative materials]. It is concluded that the CAD/CAM materials were designed with comfort for a better adaptation and durability of the parts, with excellent survival rates and reduction of clinical and laboratory time, offering the patient, shorter clinical sessions and superior quality restorations to the systems conventional. All those mentioned in this review present advantages and advantages of each material, and it is up to the professional to select the best one for each specific clinic, in each situation of materials and against indications of materials(AU)

Cytotoxicity and effects of curcumin and cinnamaldehyde hybrids on biofilms of oral pathogens.

The objective of the study was to evaluate the cytotoxicity and effect of curcumin-cinnamaldehyde hybrids (CCHs) on the biofilm of oral pathogens. Of the 18 hybrids tested, nine had an inhibitory effect on at least one of the bacterial species tested, with minimal inhibitory and bactericidal concentrations ranging from 9 to 625 µg ml-1. CCH 7 promoted a potent inhibitory effect against all the bacterial species tested and better compatibility than chlorhexidine (CHX). CCH 7 also presented a similar or improved effect over that of CHX, causing a reduction in bacterial metabolism and viability in single and dual-species biofilms. CCH 7 reduced by 86% and 34% the viability of multispecies biofilms formed by collection and clinical strains. It can be concluded that CCH 7 was cytocompatible at the minimal inhibitory concentration, presented anti-biofilm action against oral pathogens, and could act as an antimicrobial agent for application in endodontics.

Extended-pour and conventional alginates: effect of storage time on dimensional accuracy and maintenance of details.

OBJECTIVE: This study aimed to evaluate the dimensional stability and maintenance of details of conventional and high stability alginates up to 5-day storage. METHODS: Two types of alginates were selected (n=10) for this study, conventional (Hydrogum) and high stability alginates (Hydrogum 5), which were produced with the aid of a cylindrical metal block and a ring-shaped metal mold (Specifications 18, 19, and 25, ANSI/ADA). Ten images were obtained from the molds for the dimensional stability test, which were taken immediately after their production and at each different storage periods (15 min, 24 h, 48 h, 72 h, 96 h, and 120 h) by a digital camera. The specimens were kept hermetically sealed in plastic bags (23°C) and then used to obtain 140 (n=70) dental stone models, used in the detail reproduction test, in which the angular accuracy of three grooves (20 µm, 50 µm, and 75 µm) was observed at each period. The details reproduction accuracy was classified using a predetermined score classification. Measurements of dimensional changes were made in the Corel DRAW X6 program. The data were submitted to the Student's t-test (α?#8197;= 0.05). RESULTS: A statistically significant difference concerning the size of the matrix was observed after 24h for both alginates, and a statistically significant negative linear dimensional change (contraction) was verified after 24 h of storage (1.52% for the high stability alginate, and 1.32% for the conventional alginate). The high stability alginate kept the full details for 72 hours, while the conventional alginate, for 24 h. Both alginates reproduced the 75 µm groove at all storage periods. CONCLUSION: Impressions made with both alginates presented satisfactory clinical results when the alginates were immediately poured.

Extended-pour and conventional alginates: effect of storage time on dimensional accuracy and maintenance of details

ABSTRACT Objective: This study aimed to evaluate the dimensional stability and maintenance of details of conventional and high stability alginates up to 5-day storage. Methods: Two types of alginates were selected (n=10) for this study, conventional (Hydrogum) and high stability alginates (Hydrogum 5), which were produced with the aid of a cylindrical metal block and a ring-shaped metal mold (Specifications 18, 19, and 25, ANSI/ADA). Ten images were obtained from the molds for the dimensional stability test, which were taken immediately after their production and at each different storage periods (15 min, 24 h, 48 h, 72 h, 96 h, and 120 h) by a digital camera. The specimens were kept hermetically sealed in plastic bags (23°C) and then used to obtain 140 (n=70) dental stone models, used in the detail reproduction test, in which the angular accuracy of three grooves (20 µm, 50 µm, and 75 µm) was observed at each period. The details reproduction accuracy was classified using a predetermined score classification. Measurements of dimensional changes were made in the Corel DRAW X6 program. The data were submitted to the Student's t-test (α?#8197;= 0.05). Results: A statistically significant difference concerning the size of the matrix was observed after 24h for both alginates, and a statistically significant negative linear dimensional change (contraction) was verified after 24 h of storage (1.52% for the high stability alginate, and 1.32% for the conventional alginate). The high stability alginate kept the full details for 72 hours, while the conventional alginate, for 24 h. Both alginates reproduced the 75 µm groove at all storage periods. Conclusion: Impressions made with both alginates presented satisfactory clinical results when the alginates were immediately poured.

RESUMO Objetivo: O presente estudo teve como objetivo avaliar a estabilidade dimensional e manutenção de detalhes de alginatos convencionais e de alta estabilidade por até 5 dias de armazenamento. Métodos: Para esse estudo, foram selecionados dois tipos de alginatos: convencional (Hydrogum) (n = 10) e de alta estabilidade (Hydrogum 5) (n = 10), sendo produzidos com o auxílio de um bloco metálico cilíndrico e um molde metálico em forma de anel (especificações 18, 19 e 25, ANSI/ADA). Para o teste de estabilidade dimensional, dez imagens foram obtidas imediatamente e para cada tempo de armazenamento (15 min, 24, 48, 72, 96 e 120 horas), realizadas por câmera digital. As amostras foram mantidas hermeticamente fechadas em sacos plásticos (23°C). Para o teste de reprodução de detalhes, as amostras foram utilizadas para obter 140 (n = 70 por grupo) modelos de gesso, sendo observada a precisão angular de três sulcos (20 µm, 50 µm e 75 µm) para cada período. A precisão da reprodução de detalhes foi classificada usando uma classificação de pontuação predeterminada. As medições das mudanças dimensionais foram feitas no programa Corel DRAW X6. Os dados foram submetidos ao teste t de Student (α = 0,05). Resultados: Foi observada diferença estatística em relação à matriz após 24h para ambos os alginatos. Uma mudança dimensional linear negativa estatisticamente significativa (contração) foi verificada após 24 h de armazenamento (1,52% para alginato de alta estabilidade; 1,32% para alginato convencional). O alginato de alta estabilidade manteve os detalhes completos por até 72 horas, enquanto o alginato convencional, por 24 horas. Os alginatos reproduziram o sulco de 75 µm para todos os períodos. Conclusão: As impressões feitas com ambos os alginatos devem ser imediatamente vazadas para se ter resultados clínicos satisfatórios.

Effect of acidic beverages on surface roughness and color stability of artificial teeth and acrylic resin.

PURPOSE: The aim was to evaluate the effect of four acidic beverages on the roughness (Ra) and color change (ΔEab) of two brands of artificial teeth and a heat-polymerized acrylic resin (HPAR) for use in a prosthetic base. MATERIALS AND METHODS: All materials were divided into 5 groups, according to the used acidic beverage (artificial saliva - control, red wine, orange juice, coke-based, and lemon juice-based soft drink). The immersion process was divided into two stages: T1 - immersion in the acidic solutions for 10 minutes for 14 days; T2 - after T1, the samples were immersed in grape juice for 14 days. The Ra of the samples was evaluated in a rugosimeter and the ΔEab in a spectrophotometer, before and after the immersions. The analysis of variance of one (ΔEab) and two factors (Ra) and Tukey were performed (α=.05). RESULTS: There was a statistical difference for roughness after immersion (T1) for Trilux and Tritone teeth, regardless of the acid solution. For Trilux teeth, all acid solutions increased Ra (P<.05). For Tritone teeth, only the coke-based soft drink did not statistically change Ra. Grape juice (T2) altered Ra only of artificial teeth (P<.05). The color was changed for all materials, after T1 and T2. CONCLUSION: In general, the acidic solutions changed the Ra and ΔEab of HPAR and artificial teeth after T1. The grape juice altered the roughness only of the artificial teeth, promoting a clinically acceptable color change in the materials.

Cytotoxicity and antimicrobial effects of citronella oil (Cymbopogon nardus) and commercial mouthwashes on S. aureus and C. albicans biofilms in prosthetic materials.

Although the effectiveness of some mouthwashes has been proven, phytotherapy is still a field to be explored as an alternative to commercial products. OBJECTIVE: To evaluate, in vitro, the cytotoxicity and efficacy of two solutions based on citronella oil (CN), on S. aureus and C. albicans biofilms (in formation-adhesion phase and 24 h-biofilm formation) on acrylic resin and nickel-chromium alloy samples (one trademark of each material), compared to two alcohol-free commercial mouthwashes. MATERIAL AND METHODS: Two solutions containing CN at concentrations of 5x and 10x the minimum bactericidal/fungicidal concentration (MBC/MFC) were prepared by microdilution. After contamination of the samples surfaces with these microorganisms, the mouthwashes (CN - 5x and 10x; CHX - 0,12% alcohol-free chlorhexidine and LT - alcohol-free essential oils) were evaluated. Mouthwash simulation was performed for 1 min at two moments, the first simulation after 4 h of microbial adhesion and 24 h-biofilm formation, and the second simulation, 6 h after the first simulation. For biofilm quantification, the number of cultured cells was evaluated by CFUs. The cytotoxicity assay was performed on HaCat epithelial cells and quantified by the MTT method. RESULTS: Tested solutions completely inhibited the growth of both microorganisms in the adhesion phase. All solutions showed inhibitory activity against 24 h-biofilm formation. However, CN led to greater microbial reduction, regardless of the surface of the sample. All solutions demonstrated a toxic effect. However, after serial dilution, CN presented the lowest cytotoxic effect. CONCLUSION: Citronella had a lower cytotoxic effect and a higher action compared to commercial solutions.

Precisão dimensional de modelos obtidos de moldes de alginato pelos métodos invertido e não invertido / Dimensional accuracy of models obtained from pouring molds by inverted and non-inverted methods

Este é um estudo cuja finalidade foi demonstrar as possíveis deformações que podem ocorrer nos modelos obtidos de moldes de alginato, dependentes da forma de vazamento. Foram obtidos 20 moldes de alginato da marca Hydrogum 5 (Zhermack, Badia Polesine, Italy), através de um modelo de resina acrílica previamente preparado, divididos em dois grupos de 10: com vazamento invertido e não invertido. Os modelos foram analisados por fotografias, mensurados por um programa de computação (Corel Draw X3 Graphics Suíte (Corel Corporation ­ USA) e comparados com o modelo padrão. Os resultados mostraram que os vazamentos invertidos e não invertidos apresentaram valores clínicos diferentes do modelo padrão, mas que na comparação entre as técnicas, dos quatro segmentos analisados, apenas um apresentou diferença estatística significante(AU)

This is a study whose purpose was to demonstrate the possible deformations that may occur in the models obtained from alginate molds, depending on the form of flow. 20 alginate molds of Hydrogum 5 (Zhermack, Badia Polesine, Italy) were obtained through a previously prepared acrylic resin model, divided into two groups of 10: with inverted and non inverted casting. The models were analyzed by photographs, measured by a computer program (Corel Draw X3 Graphics Suite (Corel Corporation - USA) and compared with the standard model.The results showed that inverted and non inverted flow presented clinical values different from the standard model, But that in the comparison between the techniques, of the four analyzed segments, only one presented significant statistical difference(AU)

Effect of Acupuncture on Post-implant Paresthesia.

Paresthesia is defined as an alteration in local sensibility, associated with numbness, tingling, or unpleasant sensations caused by nerve lesions or irritation. It can be temporary or permanent. The treatment protocol for facial paresthesia is primarily based on the use of drugs and implant removal, which may not be completely effective or may require other risk exposure when there is no spontaneous regression. However, other therapeutic modalities such as acupuncture can be used. The aim of this study is to report a case of a patient with paresthesia of the inferior alveolar nerve and pain caused by an implant surgery performed 2 years earlier. The patient received acupuncture treatment during 4 months of weekly sessions. Six points were used: Large Intestine (LI4), Large Intestine (LI11), Stomach (ST36), Liver (LR3), Extra Head and Neck (E-HN-18), and Stomach (ST5). The visual analog scale was used before and after each session for the analysis of paresthesia and pain, together with assessment of the paresthesia by delimitation of the desensitized region of the skin and presented discomfort. Pain remission and reduction in the size of the paresthesia area occurred after four sessions.

Effect of different acidic solutions on the optical behavior of lithium disilicate ceramics.

STATEMENT OF PROBLEM: The stability of the optical characteristics of dental ceramics is essential. Degradation of these materials resulting from pH or temperature alterations in the oral cavity can lead to treatment failure. PURPOSE: The purpose of this in vitro study was to evaluate the color change (ΔE), the L* coordinate, the translucency parameter, and the contrast ratio of lithium disilicate ceramic exposed to commonly used and potentially colorant solutions. MATERIAL AND METHODS: Fifty lithium disilicate specimens were prepared and divided into 5 groups according to the immersion solution (artificial saliva, orange juice, cola, coffee, and red wine). Immersions in acidic beverages were alternated in a thermocycler with artificial saliva. The control group was immersed in artificial saliva at 37°C throughout the immersion period. After 168 hours of immersion, the color parameters were assessed with a spectrophotometer and calculated using the because system on 2 backgrounds (black and white) and in 2 time periods, before thermocycling and after thermocycling. Data were submitted to analysis of variance followed by the Tukey honest significant difference test (α=.05). RESULTS: Greater color change (ΔE) and lower L* coordinate values were observed after immersion in orange juice and cola. Regarding the translucency parameter and contrast ratio, the immersion in coffee resulted in greater opacity and lower translucency of the material. CONCLUSIONS: Alterations in the color stainability, the L* coordinate values, the translucency parameter, and the contrast ratio of the lithium disilicate ceramic were observed, according to the acidic solutions tested.

Fratura de côndilo mandibular não tratada e disfunção temporomandibular: relato de caso / Untreated mandibular condyle fracture and temporomandibular dysfunction: a case report

A fratura de côndilo mandibular é um dos tipos de traumas faciais mais comuns, podendo ser diagnosticado por diversos meios, sendo que uma variedade de planos de tratamentos podem ser instaurados. Este tipo de fratura configura também uma das etiologias da disfunção temporomandibular (DTM), portanto, é indispensável que o profissional realize exames minuciosos, inclusive por meio de exames complementares de imagem para o correto diagnóstico e conduta curativa, tanto da fratura, quanto da disfunção. Sendo assim, o objetivo deste estudo foi descrever um caso de fratura de côndilo mandibular não tratada seguida de DTM. Paciente de 36 anos do gênero masculino com histórico de acidente automobilístico há cinco anos, resultando em fratura de côndilo, com diagnóstico tardio e consolidação em posição inadequada buscou tratamento na Faculdade de Odontologia de Araçatuba - UNESP. A conduta por meio do uso de placa interoclusal levou à eliminação da sintomatologia dolorosa(AU)

The condylar fracture is one of the most common types of facial trauma and can be diagnosed by different methods, and a variety of treatment plans can be used. This type of fracture also constitutes one of the etiologies of temporomandibular disorders (TMD). Therefore, it is essential that the professional conduct thorough examinations, including complementary imaging tests for the correct diagnosis and treatment of the fracture and the dysfunction. Thus, the aim of this study was to describe a case of untreated condylar fracture followed by the development of TMD. A 36-year-old male patient with a history of automobile accident five years ago, resulting in condylar fracture, sought treatment at the Aracatuba Dental School - UNESP. The fracture had late diagnosis and consolidation in a wrong position. The conduct treatment through the use of occlusal splint led to the elimination of the painful symptomatology(AU)

Does the habitual mastication side impact jaw muscle activity?

OBJECTIVE: To compare electrical activity in the anterior temporal and masseter muscles on the habitual (HMS) and non-habitual mastication side (NHMS), during mastication and in the mandibular postural position. In addition, the increase in electrical activity during mastication was assessed for the HMS and NHMS, analysing both working (WSM) and non-working side during mastication (NWSM). METHODS: A total of 28 healthy women (18-32 years) participated in the study. They were submitted to Kazazoglu's test to identify the HMS. Bioresearch 'Bio EMG' software and bipolar surface electrodes were used in the exams. The exams were conducted in the postural position and during the unilateral mastication of raisins, on both the HMS and NHMS. The working and non-working side on HMS and NHMS were assessed separately. The obtained data were then statistically analysed with SPSS 20.0, using the Paired Samples Test at a significance level of 95%. RESULTS: The differences in the average EMG values between HMS and NHMS were not statistically significant in the postural position (Temporal p=0.2; Masseter p=0.4) or during mastication (Temporal WSM p=0.8; Temporal NWSM p=0.8; Masseter WSM p=0.6; Masseter NWSM p=0.2). Differences in the increase in electrical activity between the masseter and temporal muscles occurred on the working side, on the HMS and NHMS (p=0.0), but not on the non-working side: HMS (p=0.9) and NHMS (p=0.3). The increase in electrical activity was about 35% higher in the masseter than in the temporal muscle. CONCLUSIONS: Mastication side preference does not significantly impact electrical activity of the anterior temporal and masseter muscles during mastication or in postural position.

Antimicrobial activity of conventional and plant-extract disinfectant solutions on microbial biofilms on a maxillofacial polymer surface.

STATEMENT OF PROBLEM: Dentists often note problems with infection in patients with maxillofacial prostheses. Conventional disinfection protocols are not always effective and may alter the properties of the polymer used in the prosthesis. Thus, the search for improved disinfection methods is important. PURPOSE: The purpose of this in vitro study was to evaluate and compare the antimicrobial activity of conventional disinfectant solutions (water and neutral soap and 4% chlorhexidine) and plant extracts (Cymbopogon nardus and Hydrastis canadensis) on specimens of maxillofacial silicone contaminated with Candida albicans and Staphylococcus aureus biofilms. MATERIAL AND METHODS: Seventy-two silicone (MDX4-4210) specimens were fabricated (5×2 mm) and sterilized. Thirty-six were contaminated with C albicans (10(6) cells/mL) and 36 with S aureus (10(8) cells/mL) to evaluate the antimicrobial activity of the cleaning protocols. After incubation (37°C/72 hours), the specimens were divided into 5 groups: not disinfected (positive control), soaking in saline solution for 10 minutes, soaking in 4% chlorhexidine for 10 minutes, soaking in C nardus for 10 minutes, soaking in H canadensis for 10 minutes, and washing by hand with water and neutral soap for 30 seconds. The viability of cells was evaluated by XTT (2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide) assay and by scanning electron microscope analysis. The results were analyzed by ANOVA and the Tukey HSD test (α=.05). RESULTS: All disinfection solutions provided a statistically significant reduction in biofilm viability compared with the control group for both microorganisms (P<.05). Washing with water and neutral soap was significantly more effective in reducing biofilm viability than immersion in the disinfection solutions, with persistence of viable microorganisms between 1.05% for C albicans and 0.62% for S aureus after this cleaning protocol. Photomicrographs revealed that 4% chlorhexidine altered the surface of the polymer. CONCLUSIONS: Within the limitations of this in vitro study, it was concluded that the cleaning protocols with different disinfectant solutions produced a significant reduction in the viability of C albicans and S aureus biofilms on the silicone polymer. Washing with water and neutral soap was the most effective protocol against both microorganisms.

Comparison of conventional and plant-extract disinfectant solutions on the hardness and color stability of a maxillofacial elastomer after artificial aging.

STATEMENT OF PROBLEM: Silicone elastomers undergo physical and chemical degradation with disinfecting solutions. Phytotherapy may be a suitable solution for disinfection. However, its effect on the properties of the silicone material is unknown. PURPOSE: The purpose of this in vitro study was to evaluate the effect of disinfection with conventional and plant-extract solutions and of artificial aging on the hardness and color stability of a facial silicone associated with pigments and an opacifier. MATERIAL AND METHODS: Four hundred specimens of silicone (MDX4-4210) were fabricated (5×6 mm). Two pigment shades and 1 dry opacifier were combined in the tested material, and 4 groups (n=10) were obtained: colorless (GI), colorless with opacifier (GII), medium pigment with opacifier (GIII), and black pigment with opacifier (GIV). Specimens were subjected to disinfection (30 days) using saline solution, water, and neutral soap (digital friction, 30 seconds), chlorhexidine 4%, Hydrastis canadensis, and Cymbopogon nardus extracts (immersion, 10 minutes). Shore A hardness (ASTM D2240) and color analyses were performed before and after disinfection. Specimens were then exposed to 1008 hours of artificial aging (ASTM 53) and subjected to final hardness and color readings. The results were analyzed with ANOVA and the Tukey significant difference test (α=.05). RESULTS: The opacifier increased the hardness (GII). For GII, the H. canadensis solution and the friction with water and soap promoted significantly reduced hardness; the friction also promoted a reduction in this property for GIV. The GIII was not affected after disinfection. A significant difference was found between the ΔE values of the specimens disinfected with H. canadensis, C. nardus, and chlorhexidine, and specimens subjected to saline solution and neutral soap. CONCLUSION: The hardness of MDX4-4210 after the experimental procedure was considered clinically acceptable for facial prostheses. All groups showed clinically unacceptable color alterations regardless of the disinfecting solution.

Prosthetic rehabilitation of a patient after a partial mandibulectomy.

INTRODUCTION: The treatment of orofacial tumors may cause facial deformities by losses of structures that affect basic functions, i.e. feeding, speech, and the reduction of patient self-steam. PRESENTATION OF CASE: A white male patient was diagnosed with epidermoid cancer on the mandibular alveolar ridge with infiltration staging IV A. The patient was submitted to a mandibulectomy associated with a complete extraction of mandibular teeth. For rehabilitation, a conventional denture for the mandibular arch and a removable partial denture for the maxillary arch were fabricated. A correct occlusal adjustment and a satisfactory amount of alveolar bone was favorable for conventional dentures of the prostheses bases improve their retention and stability. After one year of follow-up, the patient was adapted to the prostheses, satisfied with their retention, and reported an improvement on his feeding. DISCUSSION: The prosthetic rehabilitation of patients after a partial mandibulectomy is essential for their self-steam. Conventional dentures may have their retention and stability improved if they are well fabricated, recorded and have a balanced occlusion. CONCLUSION: A correct occlusal adjustment and an adequate retention of the prostheses bases may improve their retention and stability. Patients without xerostomy and with a satisfactory amount of alveolar bone may have a favorable prognosis for conventional dentures.

Stress distribution in bone simulation model with pre-angled implants.

The aim of this study was evaluate the biomechanical behaviour of prostheses screwed into conventional (0° angulation) and pre-angled experimental (8, 12 and 20°) external hexagon implants (13 × 4 mm) by photoelastic analysis. Eight casts were made in photoelastic resin. Casts were divided into groups of single crowns or three combined elements. Each unit was positioned in a circular polariscope. By using a universal testing machine, 100 N loads were applied in the axial and oblique (45°) directions to fixed points on the occlusal surfaces of the crowns. Generated stresses were recorded photographically and analysed qualitatively in a graphics program. In single-element prostheses, the number of high-stress fringes increased with increasing implant angle. However, in three-element prostheses, there was no difference in the stress distribution with implant angle, except for the 12° implant that had a higher degree of stress. For the other groups pre-angulation of the implant increases the concentration and intensity of stresses for single prosthesis and has similar stress distribution in three-element fixed prostheses.