Stomatognathic adaptive motor syndrome is the correct diagnosis for temporomandibular disorders.

Temporomandibular disorder is a generic and inadequate conception to be used as a diagnosis. It fails to express the etiology or the pathophysiology and it is mainly associated with the anatomical site. Moreover, the clinical condition presents a mandibular motor problem and not a joint problem. The hypothesis presents the new diagnosis stomatognathic motor adaptive syndrome, which comprehend a motor response and the adaptive processes it induces. Inadequate occlusal contacts cause the mandible to shift in order to reach an ideal intercuspal position. The condylar displacements are proportional to such movements. Temporomandibular joint (TMJ) receptors respond to the capsular mechanical stress and the information reaches the trigeminal sensory nuclei. The mandibular modified position seems to be relevant information and may interfere with catecholaminergic neurotransmission in basal ganglia. The main motor responses comprise increased jaw muscle tone, decreased velocity of movements and incoordination. The overload of muscle function will produce adaptive responses on many stomatognathic structures. The muscle adaptive responses are hypertonia, pain, fatigue and weakness. Temporomandibular joint presents tissue modification, disc alteration and cracking noise. Periodontium show increased periodontal membrane, bone height loss and gingival recession. Teeth manifest increased wear facets, abfraction and non-accidental fractures. The periodontal and teeth adaptive processes are usually identified as occlusal trauma. The altered stomatognathic functions will show loss of velocity during mastication and speech. Fatigue, weakness in jaw muscle and difficulties to chew hard food are related to hypertonia. Incoordination between stomatognathic muscles groups is found, causing involuntary tongue/cheek biting and lateral jaw movements on speech. Otologic complaints, as aural fullness and tinnitus, are related to the tensor tympani muscle, innervated by the trigeminal nerve.

A eletromiografia como auxílio na conduta terapêutica após cirurgia de craniotomia fronto-temporal: relato de caso / Electromyography as an aid in therapeutic behavior after fronto-temporal craniotomy surgery: case report

TEMA: eletromiografia e conduta terapêutica. PROCEDIMENTOS: este estudo foi realizado com uma paciente de 45 anos de idade, após 4 meses ser submetida a craniotomia fronto-temporal proveniente de um aneurisma. O músculo temporal anterior direito foi retirado da sua origem móvel e após a cirurgia, a paciente apresentou disfunção do músculo temporal e da articulação temporomandibular, com redução da abertura de boca, dor ao falar e comer. Utilizou-se a eletromiografia para registrar quantitativamente a atividade elétrica dos músculos temporais e masseteres na avaliação e durante o processo terapêutico. Registraram-se, na posição de repouso, oclusão máxima e mastigação habitual provocada. Fez-se terapia miofuncional durante todo o processo. RESULTADOS: dados dos exames mostraram um aumento significativo da atividade elétrica do músculo temporal anterior direito e uma redução da atividade do músculo temporal anterior esquerdo, o que no primeiro registro mostrava uma atividade elétrica rebaixada do lado direito em comparação com o lado esquerdo. Com a seleção dos exercícios miofuncionais houve uma participação mais efetiva do músculo temporal anterior direito, abertura de boca maior, sem dor, facilitando a função da mastigação e da fala, harmonizando o sistema estomatognático. CONCLUSÃO: registros comparativos dos exames de eletromiografia em diferentes etapas do processo terapêutico auxiliaram e direcionaram a melhor conduta terapêutica fonoaudiológica. Conseguiu-se atingir um equilíbrio das funções de respiração, sucção, mastigação, deglutição e fala relacionadas ao sistema estomatognático, considerando as limitações do caso.

BACKGROUND: electromyography and therapeutic behavior. PROCEDURES: this study was carried out with a woman, 45year old, after 4 months from being submitted to fronto-temporal craniotomy originated an aneurysm. The right anterior temporal muscle was removed from its insertion. After the surgery, the patient had dysfunction in temporal muscle and in temporo-mandibular joint, with reduction of the opening of mouth, pain while speaking and eating. Electromyography was used to quantitatively record the electrical activity of the temporal and masseter muscles in the initial evaluation and during the therapeutic process. Records were made at rest position, maximum occlusion and chew. They did miofuncional therapy throughout the process. RESULTS: examination data showed a significant increase in the electrical activity of the right anterior temporal muscle and a reduction in the activity of the left anterior temporal muscle. The initial Record showed a lower electrical activity on the right side compared to the left. With the miofunctional exercises there was a more effective participation of the right anterior temporal muscle, greater openness of mouth, without pain, making easier chewing and speech tasks, harmonizing the stomatognathic system. CONCLUSION: comparative records concerning electromyography in different stages of the therapeutic process helped and directed the best therapy, achieving a balance concerning the functions of breathing, sucking, chewing, swallowing and speech related to the stomatognathic system, considering the limitations of the case.

[Influence of propyl-thiouracil-induced hypothyroidism on rat gingival mucosa]. / Influência do hipotireoidismo induzido por propiltiouracil na mucosa gengival do rato.

This work aimed at verifying the influence of propyl-thiouracil (PTU)-induced thyroid hormone deficiency on gingival mucosa of young male rats, measuring total protein concentration, collagen content and DNA concentration as indices of cellular population. Fifty Sprague-Dawley rats were used. The animals were grouped in: PTU-treated (i.p. 10 mg/d) and control rats (C). The experience was maintained for a period of 10 weeks. Total protein content of gingival mucosa tissue was determined by the Lowry method; hydroxyprolin rate, as prototype amino acid of collagen, was determined using the Newman method, and DNA concentration was measured by Burton's methodology. The results showed decreased amounts of PTU-treated rats gingival total protein content (PTU= 41.23 +/- 24.05 vs. C= 63.36 +/- 18.05); no alterations were seen in hydroxyprolin concentration neither in DNA content of PTU treated rats, respectively (PTU= 2.18 +/- 1.48 vs. C= 2.29 +/- 1.51) and (PTU= 0.33 +/- 0.19 vs. C= 0.46 +/- 0.41). Thus, PTU treatment promotes a decrease in total protein content of rat gingival mucosa that may be interpreted as a decrease in protein synthesis induced by the hypothyroid condition, but with no alteration either in collagen or nucleic acid rates.

Influência do hipotireoidismo induzido por propiltiouracil na mucosa gengival do rato / Influence of propilthiouracil-induced hypothyroidism on rat gingival mucosa / Influence of propilthiouracil-induced hypothyroidism on rat gingival mucosa

O objetivo foi verificar a influência da deficiência dos hormônios tireoideanos induzida por propiltiouracil (PTU) na mucosa gengival do rato, analisando bioquimicamente as proteínas totais, colágeno (hidroxiprolina) e população celular (DNA). Foram utilizados 50 ratos machos da cepa Sprague-Dawley, separados em 2 grupos: propiltiouracil (PTU) (10 mg/d i.p.), e controle (C), durante 10 semanas. As proteínas totais foram determinadas pelo método de Lowry, a hidroxiprolina pelo método de Newman e DNA pelo método de Burton. Observou-se diminuição das proteínas totais no grupo PTU (PTU= 41,23 ± 24,05; C= 63,36 ± 18,05); não houve diferença na hidroxiprolina e DNA (PTU= 2,18 ± 1,48; C= 2,29 ± 1,51) e (PTU= 0,33 ± 0,19; C= 0,46 ± 0,31). Conclui-se que o tratamento com PTU diminui o conteúdo de proteínas totais na mucosa gengival do rato, provavelmente pela diminuição da síntese protéica, sem alteração do colágeno e da população celular.

This work aimed at verifying the influence of propilthiouracil (PTU)-induced thyroid hormone deficiency on gingival mucosa of young male rats, measuring total protein concentration, collagen content and DNA concentration as indices of cellular population. Fifty Sprague-Dawley rats were used. The animals were grouped in: PTU-treated (i.p. 10 mg/d) and control rats (C). The experience was maintained for a period of 10 weeks. Total protein content of gingival mucosa tissue was determined by the Lowry method; hydroxyprolin rate, as prototype aminoacid of collagen, was determined using the Newman method, and DNA concentration was measured by Burton's methodology. The results showed decreased amounts of PTU-treated rats gingival total protein content (PTU= 41.23 ± 24.05 vs. C= 63.36 ± 18.05); no alterations were seen in hydroxyprolin concentration neither in DNA content of PTU treated rats, respectively (PTU= 2.18 ± 1.48 vs. C= 2.29 ± 1.51) and (PTU= 0.33 ± 0.19 vs. C= 0.46 ± 0.41). Thus, PTU treatment promotes a decrease in total protein content of rat gingival mucosa that may be interpreted as a decrease in protein synthesis induced by the hypothyroid condition, but with no alteration either in collagen or nucleic acid rates.