Impact of chronic allergic rhinitis on bite force and electromyographic activity of masseter and temporalis muscles of adult women.

BACKGROUND: The aim of this study was to analyse the stomatognathic system of adult women with chronic allergic rhinitis by means of molar bite force and electromyographic activity of the masseter and temporalis muscles. MATERIAL AND METHODS: A total of 26 subjects were screened and divided into two distinct groups: chronic allergic rhinitis group (n = 13) and healthy control group (n = 13). Subjects were assessed by maximal molar bite force (right and left) and normalized electromyographic activity of mandibular tasks (rest, right and left laterality, protrusion and maximal voluntary contraction). Data were submitted to Student's t test (p< .05). RESULTS: There was significant difference in right (p = .03) and left (p = .04) maximal molar bite force with force reduction in the chronic allergic rhinitis group. There was significant difference in normalized electromyographic activity in maximal voluntary contraction in the right (p =.01) and left (p = .01) temporalis muscles, with increased electromyographic activity in the masticatory muscles for the chronic allergic rhinitis group. CONCLUSIONS: The results suggest that chronic allergic rhinitis in adult women promoted negative changes in the electromyographic activity of temporalis muscles in maximal voluntary contraction and maximal molar bite force. Key words:Rhinitis, occlusal force, electromyography, masticatory muscles.

Influence of metal bar lever-arm on screws detorque for dental prosthesis implant supported / Influência do cantilever no destorque de parafusos de barras metálicas utilizadas em próteses do tipo protocolo de Brannemark

Introduction: The cantilever length of implant-supported fixed prosthesis metal structure has been considered an important factor to transfer occlusion forces to the dental implant. Objective: This study evaluated the influence of different extensions of cantilevers of Branemark protocol implant prosthesis when submitted to mechanical thermocycling by screw loosening evaluation. Material and method: The groups G10 (n = 5), G15 (n = 5) and G20 (n = 5) were formed according to the distance in millimeters between the force application site in the cantilever and the center of the last implant. All metal structures (n = 15) were submitted to a 120 N cyclic vertical load in a chewing simulation machine (MSM-Elquip, São Carlos-SP, Brazil) under controlled temperature and moisture conditions. Two hundred and fifty thousand mechanical cycles were performed with a frequency of 2 Hz that simulates a masticatory activity similar to 3 months. To compare the data obtained regarding the loosening of the metal structure screws, implant position and sites of load application, the analysis of variance with two factors and the Tukey test were performed. Result: Statistical analysis showed that the G10 group presented greater torque loss, statistically different from G15 (p = 0.001) and G20 (p = 0.002), and there was no significant difference between groups G15 and G20. Conclusion: It can be concluded from the results that all the screws presented torque loss after simulation of 3 month masticatory activity, suggesting the need for periodical evaluation to prevent failures in the treatment.

Introdução: O comprimento do cantilever da infraestrutura de prótese implanto-suportada tem sido considerado um importante fator de transferência de força de oclusão para o implante dentário. Objetivo: Esse trabalho avaliou a influência das diferentes extensões do cantilever da prótese sobre implantes tipo protocolo de Branemark submetidas à termociclagem mecânica pela avaliação dos afrouxamentos dos parafusos de fixação. Material e método: Os grupos G10 (n=5), G15 (n=5) e G20 (n=5) foram formados de acordo com a distância, em milímetros, entre o local de aplicação de força no cantilever e o centro do último implante. Todas as barras (n=15) foram submetidas a carga vertical cíclica de 120 N em uma máquina de simulação de mastigação (MSM-Elquip, São Carlos/SP, Brasil), em condições de temperatura e umidade controladas. Foram realizados 250 mil ciclos mecânicos com frequência de 2 Hz que simulou uma atividade mastigatória correspondente a 3 meses. Para comparar os dados obtidos quanto à soltura dos parafusos da barra, a posição dos implantes e os locais de aplicação de carga, foi realizada a análise de variância com dois fatores e o teste de Tukey. Resultado: A análise estatística mostrou que o grupo G10 apresentou maior perda de torque, diferente estatisticamente de G15 (p=0,001) e G20 (p=0,002) e que não houve diferença significante entre os grupos G15 e G20. Conclusão: Pode-se concluir que todos os parafusos apresentaram perda de torque após o ensaio simulando uma atividade mastigatória de 3 meses, sugerindo a necessidade de avaliação clínica periódica afim de prevenir fracasso no tratamento.

Evaluation of Marginal Misfit of Metal Frameworks Welded by Gas-Torch, Laser, and Tungsten Inert Gas Methods.

PURPOSE: The objective of this study was to evaluate the marginal fit and the flexural resistance of nickel-chromium frameworks welded by different techniques, gas-torch, laser, and tungsten inert gas (TIG), compared with that of frameworks made via one-piece casting. METHODS: To evaluate the marginal fit, a master model was fabricated simulating four implants. Transfers and replicas were used to transfer the positions of the implants to the model, using a silicone matrix. The bars were waxed up and casted. Three assessments of misfit were performed for each implant using a stereomicroscope before and after welding in two predetermined regions, totaling six readings for each implant. To evaluate the flexural resistance, one group was made casting the specimens in one piece. Other 3 groups using gas-torch, laser, and TIG welding techniques were made after sectioned transversally. The data showed normal distribution and two-way ANOVA for marginal fit and one-way ANOVA for flexural resistance, and Tukey's posttest (α=0.05) was performed. RESULTS: For the marginal fit, the three welding methods presented similar results and were different from one-piece casting. For the flexural resistance, significant differences were observed among the studied groups (p < 0.001), and the one-piece group presented higher resistance compared to the three welding techniques. CONCLUSIONS: Within the limits of this study, the three welding techniques yielded similar misfit results, and the laser and TIG techniques presented similar flexural resistance but lower than gas-torch and one-piece casting.

Removal of Implant and New Rehabilitation for Better Esthetics.

Tooth loss can result in loss of facial esthetics, in addition to its effect on mastication, swallowing, and speech. Adequate planning is required in order for the prosthetic treatment of the teeth and implants to be successful. Here, we present a clinical case demonstrating that improper positioning of an implant can make prosthetic rehabilitation unfeasible, necessitating new surgical and rehabilitation planning to achieve the desired esthetics. The patient had a missing right lateral incisor and cuspid, and a buccally directed implant. The preferred treatment regimen involved the removal of this implant and placement of another one more properly positioned distally and three dimensionally. The repositioning of the implant made rehabilitation treatment with a mesial cantilever possible. Due to esthetic considerations, gingival conditioning in the cantilever region was performed in the temporary prosthesis phase. The changes adopted in planning the surgery and rehabilitation resulted in good esthetics as well as functional outcomes.

Prótese parcial fixa conservadora com duplo sistema de fixação: relato de caso

Objetivo: apresentar uma alternativa conservadora de tratamento, com duplo sistema de fixação, em um caso de insucesso com prótese parcial fixa adesiva. Relato de caso: paciente do gênero feminino, 41 anos de idade, compareceu para tratamento na Faculdade de Odontologia de Ribeirão Preto com uma prótese parcial fixa adesiva, na região do dente 36, com deficiência na retenção e necessidade recorrente de fixação. No exame clínico, verificou-se desadaptação dos retentores metálicos nas faces linguais dos dentes pilares, tornando inviável a refixação da peça. Os preparos realizados nos dentes apresentavam deficiências na extensão e na ausência de apoios nas cristas marginais e paralelismo entre os dentes preparados. Como tratamento, foram realizadas restauração da morfologia dos dentes pilares com resina composta e confecção de uma prótese parcial fixa ultraconservadora, que resultou na manutenção das características de preparos com reduzido desgaste, restabelecimento da estética e da oclusão e eficácia na retenção da peça protética. Considerações finais: pode-se considerar que a prótese parcial fixa ultraconservadora, além de indicada para pequenos espaços edêntulos, com objetivo principal de preservação de estrutura dental, apresenta excelente sistema de fixação no substrato e pode ser utilizada como terapia alternativa em caso de insucesso da prótese parcial fixa adesiva.

Ultraconservative fixed partial denture: esthetic and preservation of dental structure / Prótese parcial fixa ultraconservadora: estética com preservação de estrutura dental

The oral rehabilitation can be made with several ways with the objective to reestablish the masticatory function and the esthetic of the patient. The aim of this clinical case is to present a different type of fixed partial denture, as alternative option to the dental surgeon, showing particularities like indications, contraindications, advantages, disadvantages and technical procedures necessary to its fabrication. The sequential presentation of the realized procedures emphasized the unique aspects of the dental preparation, impression techniques, and cautions during metal structures and ceramic try-in procedures, and esthetic overlay on the metal with composite resin. As a result, it could be observed that the ultraconservative fixed partial denture required lesser removal dental structure, re-established the esthetic and the occlusion of the patient. Finally, it can be concluded that the ultraconservative fixed partial denture is a treatment option to be used in the small prosthetic space with success both mechanically and esthetically.

A reabilitação oral pode ser realizada de diversas formas com o intuito de restabelecer a função mastigatória e a estética do paciente. Este caso clínico tem o objetivo de apresentar um tipo diferente de prótese parcial fixa, como opção alternativa para o cirurgião-dentista, mostrando suas particularidades quanto à indicação, contraindicação, vantagens, desvantagens e procedimentos necessários à sua elaboração. A apresentação sequencial dos procedimentos realizados ressaltou os aspectos únicos do preparo dental, da técnica de moldagem, dos cuidados a serem observados na prova da estrutura metálica, na prova da cerâmica, dos aspectos diferenciais na cimentação e do recobrimento estético da estrutura metálica com resina composta. Como resultado pode-se observar que a prótese ultraconservadora exigiu menor desgaste estrutural dos dentes pilares, restabeleceu a estética e a oclusão do indivíduo. Diante disso, pode-se concluir que a prótese parcial fixa ultraconservadora é uma opção de tratamento a ser utilizada em pequenos espaços protéticos com sucesso mecânico e estético.

Avaliação da resistência flexural entre diferentes métodos de soldagem / Evaluation of flexural strength among different welding methods

A técnica de soldagem, muito utilizada em prótese parcial fixa, permite a união das partes metálicas, favorecendo a adaptação da prótese e a distribuição das forças mastigatórias, minimizando falhas no tratamento reabilitador. O objetivo deste trabalho foi avaliar a resistência flexural dos métodos de soldagem com chama direta, laser e TIG, utilizando uma liga de NiCr. Um grupo controle (M) foi confeccionado fundindo os corpos de prova em monobloco. Foram confeccionados três grupos: chama direta (C), laser (L) e TIG (T), onde os corpos de prova foram seccionados transversalmente. Em razão das características das soldagens laser e TIG que ocorrem apenas perifericamente, foram realizados outros dois grupos: laser (L1) e TIG (T1), em que os corpos de prova foram seccionados em chanfro de 45º. Os corpos de prova tiveram suas extremidades unidas com resina duralay e cada grupo passou pelo seu respectivo processo de soldagem, torneamento, simulação de cocção da porcelana e, finalmente, submetidos aos testes de flexão. Os valores numéricos registrados foram de 1,79 GPa (M), 1,37 GPa (C), 0,99 GPa (T), 1,26 GPa (T1), 1,03 GPa (L) e 1,09 GPa (L1). Os dados obtidos foram submetidos à análise estatística (Anova – p < 0,5). Concluiu-se que todos os grupos laser e TIG apresentaram resultados semelhantes entre si; os grupos laser e TIG com preenchimento foram semelhantes ao grupo chama e todos os grupos soldados foram diferentes estatisticamente do grupo controle.

Soldering methods used to join fixed partial dentures favor prosthesis fit and distribution of masticatory forces, minimizing failures in the oral rehabilitation process. The aim of this work was to evaluate the flexural strength of different soldering methods as brazing, TIG, and laser welding using a Ni-Cr alloy. A control group (M) was made using one-piece castings. Also, other three groups were made by brazing (C), TIG (T), and laser (L) being sectioned in a transversal direction. Another two groups were ssectioned in a 45-degree chanfer configuration. The specimens were joined with acrylic resin and submitted to flexural tests. The numerical values were 1,79 GPa (M), 1,37 GPa (C), 0,99 GPa (T), 1,26 GPa (T1), 1,03 GPa (L) e 1,09 GPa (L1). The Anova test (p=0.05) was performed to identify possible significant differences among groups. The conclusions were: all Laser and TIG groups were statistically similar with the brazing group and all the experimental groups were statistically different from the control group.

Reestablishment of occlusion through overlay removable partial dentures: a case report.

Loss of posterior teeth may cause an imbalance in the stomatognathic system. Overlay removable partial dentures (ORPD) are a reversible and relatively inexpensive treatment for patients with severely worn teeth. This paper presents a treatment with ORPD in a 55-year-old male patient who had severe attrition in the maxillary and mandibular teeth, temporomandibular joint pain and reduced vertical dimension of occlusion (VDO). The treatment consisted in the reestablishment of the VDO using Lucia's jig, fabricating removable partial denture with reconstruction of the worn teeth without preparation. This therapy can be used as an alternative treatment to provide esthetic, function and stable occlusion in patients with severely worn teeth.

Reestablishment of occlusion through overlay removable partial dentures: a case report

Loss of posterior teeth may cause an imbalance in the stomatognathic system. Overlay removable partial dentures (ORPD) are a reversible and relatively inexpensive treatment for patients with severely worn teeth. This paper presents a treatment with ORPD in a 55-year-old male patient who had severe attrition in the maxillary and mandibular teeth, temporomandibular joint pain and reduced vertical dimension of occlusion (VDO). The treatment consisted in the reestablishment of the VDO using Lucia’s jig, fabricating removable partial denture with reconstruction of the worn teeth without preparation. This therapy can be used as an alternative treatment to provide esthetic, function and stable occlusion in patients with severely worn teeth.

A perda de dentes posteriores pode provocar o desequilíbrio do sistema estomatognático. As próteses parciais removíveis terapêuticas atuam como terapia reversível e não dispendiosa para os pacientes com desgastes dentais severos. Este trabalho apresenta um tratamento com as próteses parciais removíveis terapêuticas (overlay) em um paciente de 55 anos, do gênero masculino que apresentava atrição severa nos dentes superiores e inferiores, dor na articulação temporomandibular e dimensão vertical de oclusão reduzida. O tratamento consistiu em restabelecer a dimensão vertical de oclusão utilizando o Jig de Lucia, próteses parciais removíveis com reconstrução dos dentes desgastados e sem preparos. Esta terapia pode ser utilizada como uma alternativa de tratamento para a obtenção de estética, função e estabilidade oclusal em pacientes com desgastes dentais severos.

Efeito da placa oclusal resiliente nos músculos masseter e temporal em pacientes com disfunção temporomandibular / Effect of soft occlusal splint in masseter and temporal muscles patientswith temporomandibular dysfunction

Introdução: A disfunção temporomandibular é uma alteração patológica que afeta os músculos da mastigação, a articulação temporomandibular ou ambos, e vem se tornando cada vez mais frequente na Odontologia. Objetivo: O objetivo deste estudo foi analisar o efeito do tratamento com placa oclusal resiliente na atividade eletromiográfica dos músculos masseter e temporal, e na força de mordida molar máxima em pacientes portadores de disfunção temporomandibular. Material e método: Foram selecionados 12 pacientes do Serviço de Dor Orofacial e Disfunção Temporomandibular do Centro de Pacientes Especiais da FORP USP com disfunção temporomandibular, diagnosticados pelo índice RDC TMD, e submetidos a exames eletromiográficos e de força de mordida molar máxima antes, 45 e 90 dias após o uso noturno da placa oclusal resiliente. Resultado: As médias eletromiográficas normalizadas obtidas dos músculos masseter e temporal durante as condições clínicas de repouso, protrusão, lateralidade direita e esquerda, apertamento dental em contração voluntária máxima e a força de mordida molar máxima direita e esquerda foram analisadas estatisticamente utilizando o software aspas Statistical Package for the Social Sciences aspas SPSS versão 17,0 (Chicago, IL), tendo sido executado o teste-t pareado. Os dados foram submetidos à análise estatística com um nível de confiança de 95% (p < 0,05). Conclusão: Os autores observaram que, após o uso da placa oclusal resiliente nas condições clínicas propostas, ocorreram alterações satisfatórias nos valores eletromiográficos e houve um aumento da força de mordida.

Introduction: Temporomandibular dysfunction is a pathological change that affects the muscles of mastication, the temporomandibular joint or both and is becoming more and more frequent in dentistry. Objective: The aim of this study was to analyze the effect of treatment with soft occlusal splint on the electromyographic activity of masseter and temporal muscles and maximal molar bite force in patients with temporomandibular disorders. Material and Method: Were selected twelve patients in the Department of Orofacial Pain and Temporomandibular Disorders Center Patient Special FORP USP with temporomandibular disorder, diagnosed by the RDC TMD index, and underwent an examination of EMG and maximal molar bite force before forty and five to ninety days after the nightly use of soft occlusal splints. Result: The mean normalized EMG obtained from the masseter and temporal muscles obtained during the clinical conditions of rest, protrusion, right and left laterality, clenching in maximum voluntary contraction force and maximal molar bite right and left were statistically analyzed using the software aspas Statistical Package for the Social Sciences aspas SPSS version 17,0 (Chicago, IL), where he was executed the paired t-test, Data were subjected to statistical analysis (SPSS 17,0) with a confidence level of 95% (p < 0.05). Conclusion: The authors observed that after using the occlusal soft occlusal splint in clinical conditions satisfactory changes occurred quotes, on the values electromyographic and there was an increase in the strength of bite.

Measurements of jaw movements and TMJ pain intensity in patients treated with GaAlAs laser.

The aim of this study was to evaluate the effectiveness of low-level laser therapy (LLLT) on the improvement of the mandibular movements and painful symptoms in individuals with temporomandibular disorders (TMD). Forty patients were randomly divided into two groups (n=20): Group 1 received the effective dose (GaAlAs laser λ 830 nm, 40 mW, 5J/cm²) and Group 2 received the placebo application (0 J/cm²), in continuous mode on the affected condyle lateral pole: superior, anterior, posterior, and posterior-inferior, twice a week during 4 weeks. Four evaluations were performed: E1 (before laser application), E2 (right after the last application), E3 (one week after the last application) and E4 (30 days after the last application). The Kruskal-Wallis test showed significant more improvements (p<0.01) in painful symptoms in the treated group than in the placebo group. A significant improvement in the range of mandibular movements was observed when the results were compared between the groups at E4. Laser application can be a supportive therapy in the treatment of TMD, since it resulted in the immediate decrease of painful symptoms and increased range of mandibular movements in the treated group. The same results were not observed in the placebo group.

Eficiência mastigatória: análise de correlação de dois testes / Masticatory efficiency: analysis of correlation between two tests

Objetivos: Aplicar dois testes de eficiência mastigatória e verificar a existência de correlação entre eles e verificar a possibilidade de utilizar o método das cápsulas, cujos procedimentos práticos são mais simplificados, com a mesma precisão já comprovada do método que utiliza as tamises. Métodos: Os dois testes de eficiência mastigatória, com sistema de tamises e com cápsulas colorimétricas, foram aplicados em um grupo de 17 indivíduos jovens, entre 18 e 30 anos, sendo 6 do gênero masculino e 11 do feminino, com dentição natural completa. Os dados obtidos dos dois testes foram submetidos à análise estatística pelo teste de Pearson. Resultados: O resultado estatístico obtido mostrou haver uma correlação entre os dois métodos. Conclusão: Ambos os métodos são passíveis de aplicação e que a escolha por um ou outro método passa a depender da preferência do pesquisador por um método ou da facilidade proporcionada pelos equipamentos disponíveis.

Objectives: The objectives of this study were to administer two masticatory efficiency tests, verify if there is a correlation between them, and verify if the capsule method can be used since its procedures are simpler and proven to be as precise as the sieving method. Methods: Masticatory efficiency tests using the sieving system and colorimetric capsules were administered to a group of 17 individuals (6 males and 11 females) aged 18 to 30 years with all their natural teeth. The Pearson´s test was used to analyze the data obtained from the two tests. Results: The statistical results showed that there is a correlation between the two methods. Conclusion: Both methods can be used and choosing between them depends on the researcher´s preference and/or the equipment available.

Emg analysis after laser acupuncture in patients with temporomandibular dysfunction (TMD). Implications for practice.

The aim of this study was to analyze the effect of low level laser applied to acupuncture points of patients diagnosed with temporomandibular dysfunction (TMD). Ten patients aged between 20 and 50 years were clinically examined with regard to pain and dysfunction of the masticatory system. They received laser applications (GaAlAs diode laser, 780 nm wavelength; 70 mW power output, 35 j/cm(2)) in acupuncture specific points (Ig4, C3, E6, E7) once a week, for ten sessions. The range of jaw movement was registered after each session and visual analogue scale (VAS) was applied. Results were analyzed (SPSS-15.0-Chicago) during the comparison, before and after treatment. Statistical tests showed significant improvements (p < 0.01) in painful symptoms and electromyographic activities of masseter muscles in maximal habitual occlusion after laser applications but no significant improvements (p = 0.05) in measurements of mandibular movements. The laser therapy in specific acupuncture points promoted improvement of symptoms and it may be used as complementary therapy for TMD.

Measurements of jaw movements and TMJ pain intensity in patients treated with GaAlAs laser

The aim of this study was to evaluate the effectiveness of low-level laser therapy (LLLT) on the improvement of the mandibular movements and painful symptoms in individuals with temporomandibular disorders (TMD). Forty patients were randomly divided into two groups (n=20): Group 1 received the effective dose (GaAlAs laser ? 830 nm, 40 mW, 5J/cm2) and Group 2 received the placebo application (0 J/cm2), in continuous mode on the affected condyle lateral pole: superior, anterior, posterior, and posterior-inferior, twice a week during 4 weeks. Four evaluations were performed: E1 (before laser application), E2 (right after the last application), E3 (one week after the last application) and E4 (30 days after the last application). The Kruskal-Wallis test showed significant more improvements (p<0.01) in painful symptoms in the treated group than in the placebo group. A significant improvement in the range of mandibular movements was observed when the results were compared between the groups at E4. Laser application can be a supportive therapy in the treatment of TMD, since it resulted in the immediate decrease of painful symptoms and increased range of mandibular movements in the treated group. The same results were not observed in the placebo group.

O objetivo deste estudo foi avaliar a eficácia da terapia com laser de baixa intensidade na melhora dos movimentos mandibulares e dos sintomas dolorosos em pacientes com disfunção temporomandibular (DTM). Quarenta pacientes foram aleatoriamente divididos em dois grupos (n=20): Grupo 1 recebeu a dose efetiva (laser de AsGaAl 830 nm, 40 mW, 5 J/cm2) e Grupo 2 recebeu a aplicação placebo (0 J/cm2), no modo contínuo no pólo lateral do côndilo afetado: superior, anterior, e posterior-posterior e inferior, 2 vezes por semana, por 2 meses. Quatro avaliações foram feitas: A1 (antes da aplicação), A2 (imediatamente após a última aplicação), A3 (uma semana após a última aplicação) e A4 (um mes após a última aplicação). O teste estatístico de Kruskal-Wallis mostrou melhoras significativas (p<0,01) nos sintomas dolorosos no grupo 1, diferentemente do grupo 2. Uma melhora significativa na extensão dos movimentos mandibulares foi observada quando os resultados foram comparados entre os dois grupos na A4. A aplicação do laser é uma terapia de suporte no tratamento da DTM, uma vez que resultou em imediata redução dos sintomas dolorosos e aumento na extensão dos movimentos mandibulares no grupo experimental. Os mesmos resultados não foram observados no grupo placebo.

Analysis of TMJ vibration sounds before and after use of two types of occlusal splints.

Temporomandibular joint (TMJ) sounds are important and common physical signs of temporomandibular disorders (TMD). The aim of this study was to evaluate the influence of the effect of the use of occlusal bite splints (stabilizing and repositioning) on the sounds produced in the TMJ, by means of the electrovibratography (EVG). Thirty-one patients with TMD from the Dental School of Ribeirão Preto, University of São Paulo, Brazil were selected for this study. Group 1 (n=23) wore stabilizing bite splints and Group 2 (n=8) used anterior repositioning splints. Before and after treatment with occlusal splints both groups were analyzed using the SonoPAK Q/S recording system (BioResearch System, Inc.). The treatments with stabilizing bite splints were satisfactory, since they reduced the total amount of the sound energies (p<0.05), but the use of anterior repositioning splints for no more than 4 weeks produced significantly better results (p<0.01). The total amount of vibration energy involved in the vibrating movements of the TMJ showed significant improvement using anterior repositioning splints.

Analysis of TMJ vibration sounds before and after use of two types of occlusal splints

Temporomandibular joint (TMJ) sounds are important and common physical signs of temporomandibular disorders (TMD). The aim of this study was to evaluate the influence of the effect of the use of occlusal bite splints (stabilizing and repositioning) on the sounds produced in the TMJ, by means of the electrovibratography (EVG). Thirty-one patients with TMD from the Dental School of Ribeirão Preto, University of São Paulo, Brazil were selected for this study. Group 1 (n=23) wore stabilizing bite splints and Group 2 (n=8) used anterior repositioning splints. Before and after treatment with occlusal splints both groups were analyzed using the SonoPAK Q/S recording system (BioResearch System, Inc.). The treatments with stabilizing bite splints were satisfactory, since they reduced the total amount of the sound energies (p<0.05), but the use of anterior repositioning splints for no more than 4 weeks produced significantly better results (p<0.01). The total amount of vibration energy involved in the vibrating movements of the TMJ showed significant improvement using anterior repositioning splints.

Os ruídos da articulação temporomandibular (ATM) são sinais físicos importantes e comuns da disfunção temporomandibular (DTM). O objetivo do presente estudo foi avaliar o efeito do uso da placa oclusal (estabilizadora e reposicionadora) nos sons produzidos na ATM, por meio da eletrovibratografia (EVG). Um total de 31 pacientes da Faculdade de Odontologia de Ribeirão Preto - USP foram selecionados para este estudo. O grupo 1 (n=23) foi selecionado para usar a placa estabilizadora e o grupo 2 (n=8) para usar a placa reposicionadora. Antes e depois do uso das placas os grupos foram analisados usando o SonoPAK Q/S (BioResearch System). Os tratamentos com placas estabilizadoras foram satisfatórios quando analisados estatisticamente uma vez que reduziram a quantidade total de energia dos sons (p<0,05). O tratamento com placa reposicionadora, por 4 semanas no máximo, produziu melhores resultados estatísticos (p<0,01). A quantidade total de energia de vibração nos movimentos vibratórios da ATM mostrou significante melhora usando a placa reposicionadora.

Characteristics of TMD noise analyzed by electrovibratography.

Studying joint noise is an important parameter for diagnosing temporomandibular dysfunction. In this study, eight groups (n=9) were formed according to joint dysfunction classification, provided by employing vibration analysis equipment. Parameters for analyzing joint noise were: total vibration energy, peak amplitude, and peak frequency. Mouth opening range was also analyzed. Statistical analysis results for each parameter were significant at 1%. Each analyzed group presented different noise characteristics. This allowed for inclusion of the groups within a determined value category. The patient group with normal condyle/disk relationship always presented the lowest values. The type of joint noise was characterized by analyzing total integral noise, peak amplitude, peak frequency, and mouth opening. Analyzing joint noise using electrovibratography suggests the type of joint dysfunction and may help to establish a diagnosis, as well as a treatment plan.

Bite force in temporomandibular dysfunction (TMD) and healthy complete denture wearers.

The signs and symptoms of temporomandibular dysfunction (TMD) may contribute to reduce bite force and muscular activity. The aims of this study were to compare bite force in complete denture wearers with TMD (TMD group) and without TMD (healthy group).The TMD group consisted of 9 individuals, who had worn a maxillary and a mandibular complete removable denture for more than 10 years. The healthy group consisted of 9 participants who wore dentures and had satisfactory interocclusal and maxillomandibular relationship. Helkimo Index was used to analyze the dysfunction level. Maximum bite force was measured using a digital dynamometer with capacity of 100 kgf and adapted to oral conditions.The TMD group presented smaller mean bite force values than the healthy group, though without statistical significance (p>0.05). This outcome suggests that the TMD signs and symptoms and the structural conditions of the dentures did not affect the maximal bite force of complete denture wearers.

Bite force in temporomandibular dysfunction (TMD) and healthy complete denture wearers

The signs and symptoms of temporomandibular dysfunction (TMD) may contribute to reduce bite force and muscular activity. The aims of this study were to compare bite force in complete denture wearers with TMD (TMD group) and without TMD (healthy group).The TMD group consisted of 9 individuals, who had worn a maxillary and a mandibular complete removable denture for more than 10 years. The healthy group consisted of 9 participants who wore dentures and had satisfactory interocclusal and maxillomandibular relationship. Helkimo Index was used to analyze the dysfunction level. Maximum bite force was measured using a digital dynamometer with capacity of 100 kgf and adapted to oral conditions.The TMD group presented smaller mean bite force values than the healthy group, though without statistical significance (p>0.05). This outcome suggests that the TMD signs and symptoms and the structural conditions of the dentures did not affect the maximal bite force of complete denture wearers.

Os sinais e sintomas de DTM podem contribuir na redução da força de mordida e da atividade muscular. O objetivo deste trabalho foi comparar a força de mordida em indivíduos com prótese total com DTM (Grupo CDTM) e sem DTM (Grupo SDTM). O Grupo CDTM (n=9) era composto por indivíduos que utilizavam as mesmas próteses totais há mais de 10 anos. O Grupo SDTM (n=9) por indivíduos com próteses totais satisfatórias quanto aos requisitos estruturais e funcionais, observados pelo profissional e relatados pelo paciente. O índice de Helkimo foi utilizado para análise do índice de disfunção. A força de mordida máxima foi medida na região de molares com gnatodinamômetro. Os resultados mostraram que o Grupo CDTM apresentou valor numérico médio de força de mordida menor que o Grupo SDTM, porém sem diferença estatisticamente significante entre os grupos avaliados (p<0,05) sugerindo que os sinais e sintomas da DTM e as condições estruturais das próteses não afetaram os resultados da força de mordida.

Hypertrophy of the mandibular coronoid process and structural alterations of the condyles associated with limited buccal opening: case report.

This paper reports the case of a patient who presented limited buccal opening, though, without apparent symptomatology. The patient was partially toothless and exodontia of the remaining teeth was indicated. Clinical examination and clinical interview were performed as well as panoramic radiograph, transcranial radiograph of the temporomandibular joints (TMJ) and, later, computed tomography (CT), emphasizing the importance of complementary exams in the diagnostic phase. Analysis of the CT scan confirmed the structural alteration in the condylar and coronoid processes of the jaw, explaining the limited buccal opening. The remaining teeth were extracted and complete upper and lower dentures were fabricated, reestablishing the occlusal relationship and the patient's stomatognathic functions. Surgical treatment of the coronoid process was discarded.