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Artigo em Inglês | MEDLINE | ID: mdl-35692573


Introduction: Considering oral rehabilitation with dental implants, many studies have aimed at improving bone regeneration through the use of biomaterials. Objective: This study aimed at comparing bone neoformation in patients undergoing bilateral maxillary sinus surgery with two bovine biomaterials. Materials and Methods: This is a randomized, blinded, clinical crossover, and divided mouth study. Ten participants with an indication of maxillary sinus enlargement were selected and underwent surgical treatment with Bio-Oss® graft biomaterial (graft 1) on one side and Lumina-Porous® graft biomaterial (graft 2) on the other. The samples were collected after nine months and fixed and then decalcified in 10% ethylenediamine tetra-acetic acid (EDTA) solution for 30 days to process and make histological slides. Connective and bone tissue were further analyzed to identify the amount of newly formed bone. Results: The graft 1 group had a greater formation of vital mineralized tissue when compared to the graft 2 group (p = 0.01). For nonvital mineralized tissue and amount of connective tissue, there was no statistical difference (p = 0.21 and p = 0.09, respectively). The medullary spaces were larger in the graft 2 group. The group treated with graft 1 presented a higher percentage of osteoclasts and viable osteocytes compared to the graft 2 group (p = 0.014 and p = 0.027, respectively). Conclusion: Every day, new alternative biomaterials are offered as an option in oral rehabilitation. In this study, both treatments induced bone neoformation after 9 months; however, the group treated with Bio-Oss® showed a higher percentage of vital mineralized bone tissue.

J Dent Child (Chic) ; 87(2): 103-109, 2020 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-32788004


Purpose: To evaluate the prevalence of signs and symptoms of temporomandibular disorders (TMD) in children and the impact on their oral health-related quality of life (OHRQoL).
Methods: Data were collected by means of a questionnaire to evaluate the presence of TMD symptoms in eight to 10-year-old children. For those who answered at least one of the four questions in a positive manner, a clinical exam was done to confirm the diagnosis. The Child Perceptions Questionnaire (CPQ8-10) was applied to evaluate the OHRQoL. Poisson regression was used to associate the total scores and individual domains of the CPQ8-10 with sociodemographic factors and clinical conditions.
Results: A total of 245 children participated in this cross-sectional study. One hundred and twenty-one (49.4 percent) were diagnosed with TMD; 57.9 percent were females and 42.1 percent were males. Children with a diagnosis of disc displacement with reduction had a negative impact on the domain of functional limitations (rate ratio=2.61, 95 percent confidence interval=1.19 to 5.75, P =0.017).
Conclusion: The prevalence of signs and symptoms of TMD was high in our sample, and signs and symptoms of TMD had a negative impact on children's OHRQoL in the domain of functional limitations.

Qualidade de Vida , Transtornos da Articulação Temporomandibular , Brasil , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Saúde Bucal , Inquéritos e Questionários
Eur J Dent ; 12(1): 144-148, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29657540


Objectives: The objectives of this study were to assess the prevalence of temporomandibular disorders (TMDs) in patients with relapsing-remitting multiple sclerosis (MS) and to investigate whether an association exists between the presence of TMD symptoms and the degree of MS-related disability. Materials and Methods: In all, 120 individuals were evaluated: 60 patients with a diagnosis of relapsing-remitting MS and 60 age- and sex-matched controls without neurological impairments. A questionnaire recommended by the European Academy of Craniomandibular Disorders for the assessment of TMD symptoms was administered. For those who answered affirmatively to at least one of the questions, the RDC/TMD Axis I instrument was used for a possible classification of TMD subtypes. The Expanded Disability Status Scale (EDSS) was the measure of the degree of MS-related disability. Statistical Analysis Used: Fisher's exact test was used to analyze the data. ANOVA was used to detect significant differences between means and to assess whether the factors influenced any of the dependent variables by comparing means from the different groups. Results: The prevalence of TMD symptoms in patients with MS was 61.7% versus 18.3% in the control group (CG). A diagnosis of TMD was established for 36.7% in the MS group and 3.3% in the CG (P = 0.0001). There were statistically significant differences between degrees of MS-related disability and the prevalence of TMD (P = 0.0288). Conclusions: The prevalence of both TMD and TMD symptoms was significantly greater in the MS group. EDSS scores and TMD prevalence rates were inversely related.

J Oral Facial Pain Headache ; 30(2): 134-8, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27128477


AIMS: To investigate the possible relationship between the orthodontic treatment of Class II malocclusion and the development of temporomandibular disorders (TMD). METHODS: A total of 40 patients was evaluated at four time points: the day before the start of treatment employing bilateral Class II elastics (baseline), as well as at 24 hours, 1 week, and 1 month after the start of treatment. The development of TMD pain complaints in the orofacial region and changes in the range of mouth opening were assessed at these times. Shapiro-Wilk, McNemar, and Friedman tests with 5% significance level were used to analyze the data. RESULTS: The treatment produced pain of a transitory, moderate intensity, but there was no significant change from baseline after 1 month. There were no restrictions in the range of jaw motion or any evidence of limitations in mouth opening. CONCLUSION: Orthodontic treatment with bilateral Class II elastics does not cause significant orofacial pain or undesirable changes in the range of mouth opening. Furthermore, this modality of orthodontic treatment was not responsible for inducing TMD.

Transtornos da Articulação Temporomandibular/etiologia , Técnicas de Movimentação Dentária/métodos , Adolescente , Adulto , Dor Facial/etiologia , Feminino , Seguimentos , Cefaleia/etiologia , Humanos , Masculino , Má Oclusão Classe II de Angle/terapia , Mastigação/fisiologia , Aparelhos Ortodônticos , Medição da Dor/métodos , Estudos Prospectivos , Amplitude de Movimento Articular/fisiologia , Articulação Temporomandibular/fisiologia , Técnicas de Movimentação Dentária/instrumentação , Adulto Jovem
Rev. dor ; 16(4): 249-253, Oct.-Dec. 2015. graf
Artigo em Português | LILACS-Express | LILACS | ID: lil-767182


ABSTRACT BACKGROUND AND OBJECTIVES: Among temporomandibular disorder classifications, masticatory muscles myofascial pain is the most frequent. Its multifactorial etiology makes its treatment difficult. Identifying other painful sites related to temporomandibular disorders may help controlling comorbidities and, as a consequence, improving their symptoms. This study aimed at evaluating the presence of body pain in temporomandibular location. METHODS: We have evaluated 328 medical charts of the Dental Research Center São Leopoldo Mandic, with diagnosis of muscular temporomandibular disorder. Patients were evaluated by means of a body map to locate pain complaints. RESULTS: From 328 analyzed medical charts, 180 (55%) had body pain (160 females, 20 males), and 148 (45%) had facial pain only (116 females, 32 males). Areas with most frequent pain reports were cervical, lumbar and shoulders.Females had more body pain (with pain n=160, without pain n=116, p≤0.001) as compared to males (with pain n=20, without pain n=32) with statistical difference.In most cases pain has affected both body sides (bilateral face 67%, bilateral body 92%). CONCLUSION: Most patients with temporomandibular disorder had pain in body parts different from the face. Regions marked in human body drawings with more pain were cervical followed by lumbar and shoulders.

RESUMO JUSTIFICATIVA E OBJETIVOS: Dentre as classificações das disfunções temporomandibulares, as dores miofasciais nos músculos da mastigação são as mais frequentes. Sua etiologia multifatorial dificulta o tratamento. Reconhecer outros locais de dor relacionados à disfunção temporomandibular pode ajudar no controle das comorbidades e consequentemente melhorar o seu quadro. O objetivo deste estudo foi avaliar a presença de dor no corpo em pacientes com disfunção temporomandibular, a frequência desses relatos e sua localização. MÉTODOS: Foram avaliados 328 prontuários do Centro de Pesquisa Odontológica São Leopoldo Mandic, com diagnóstico de disfunção temporomandibular muscular. Os pacientes foram avaliados por meio de desenhos de mapa corporal para determinar a localização de queixas de dor. RESULTADOS: Dos 328 prontuários analisados, 180 (55%) apresentaram registro de dor pelo corpo (160 mulheres, 20 homens), e 148 (45%) apresentavam dor apenas na região da face (116 mulheres, 32 homens). As áreas com maior relato de dor foram: cervical, lombar e ombros. O gênero feminino apresentou maior frequência de dores no corpo (com dor n=160, sem dor n=116, p<0,001) que o gênero masculino (com dor n=20 e sem dor n=32) com diferença estatística. Na maior parte dos casos a dor acometeu os dois lados do corpo (face 67% bilateral e corpo 92% bilateral) CONCLUSÃO: A maioria dos pacientes com diagnóstico de disfunção temporomandibular apresentou dor em outras partes do corpo além da face. A região anotada nos desenhos do corpo humano com maior acometimento da dor foi a cervical seguida da lombar e ombros.

RGO (Porto Alegre) ; 62(1)jan.-mar. 2014. ilus
Artigo em Português | LILACS-Express | LILACS | ID: lil-712094


Objective: The present research aims to evaluate the calibration of digital palpation pressure as well as to assess the inter-examiner variation and mean pressure used by a sample consisting of 56 professionals of the TMJ disorders and Orofacial Pain area. Methods: Each participant was asked to press a digital balance to approach 1.0 kg and subsequently 0.5 kg without seeing the display, in order to obtain a blind data. The values of 1.0 kg and 0.5 kg are recommended by the Research Diagnostic Criteria for Temporomandibular Disorder in the refined Axis I, the Physical Assessment. Participants were considered calibrated when they applied the correct pressure in at least 4 of the 5 measurement taken; within a 20% variation interval (pressures between 0.4 and 0.6 kg were acceptable for the reference value of 0.5 kg and between 0.8 and 1.2 kg for the reference value of 1.0kg). The t-student test was used to analyze data (p?0.05). Results: 70% of the sample was classified as non- calibrated for the 0.5 kg pressure while 57% were not calibrated for the 1.0 kg pressure. The mean inter-examiner variations, 0.3 kg for the pressure set at 0.5kg and 0.6 kg for the pressure set at 1.0 kg, were considered high. Conclusion: The mean pressures applied by participants (0.7 kg for joint palpation and 1.4 kg for muscle palpation) were also considered high in comparison with those recommended by the Research Diagnostic Criteria for Temporomandibular Disorder, but acceptable according to the tendency of applying higher values of 1.0 - 1.5 kg, as proven by recent study.

Objetivo: Avaliar a calibra��o da for�a de palpa��o digital, bem como determinar a varia��o intra-examinador e a for�a m�dia aplicada por uma amostra composta de 56 profissionais que atuam na especialidade de disfun��o temporomandibular e dor orofacial. M�todos: Foi solicitado a cada participante que pressionasse o centro de uma balan�a digital, sem visualizar o display, o valor que acreditasse ser correspondente � 1,0 kg e, posteriormente, a 0,5 kg, recomendados pelo protocolo de exame f�sico do Eixo I do Consortium, the Research Diagnostic Criteria for Temporomandibular Disorders. Foram considerados calibrados aqueles que aplicassem a for�a correta, aceitando-se uma varia��o de 20% (entre 0,4 e 0,6 kg para o menor valor e 0,8 a 1.2 kg para o maior valor), em 4 das 5 aferi��es realizadas. Na an�lise dos dados foi utilizado o teste t de Student (p?0,05). Resultados: 70% da amostra foi classificada como n�o calibrada para a for�a de 0,5 kg e 57% n�o calibrada para 1,0 kg. A varia��o m�dia intraexaminador de 0,3 kg para o peso de 0,5 kg e 0,6 kg para o de 1,0 kg foram consideradas altas. Conclus�o: A for�a m�dia aplicada pelos participantes (0,7 kg para palpa��o articular e 1.4 kg para palpa��o muscular) foi maior que o recomendado pelo Consortium, the Research Diagnostic Criteria for Temporomandibular Disorders, entretanto encontra-se de acordo com a tend�ncia em aplicar valores mais altos entre 1,0 e 1,5 kg, validado em estudo recente.

J Orofac Pain ; 27(3): 271-5, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23882460


AIMS: To translate the Pictorial Representation of Illness and Self Measure (PRISM) instrument from German to Portuguese (Brazilian) and adapt it to the Brazilian cultural context, and then assess its reliability and validity in orofacial pain patients. METHODS: The PRISM was translated to Portuguese then back-translated to German. The translated PRISM was evaluated by a multidisciplinary committee and administered as a pre-test to 30 Portuguese-speaking orofacial pain patients. Psychometric properties were obtained after testing 116 orofacial pain patients. Validity was obtained through correlation analyses of scores obtained from PRISM and other psychometric tests, including the Numerical Pain Scale (NPS), Insomnia Severity Index (ISI), and Hospital Anxiety and Depression Scale (HAD). RESULTS: The adapted instrument showed high levels of reliability, proven by means of the test-retest procedure, and calculation of the Intraclass Correlation Coefficient (ICC = 0.991). Significant correlations were found between PRISM and the other tests. Correlation with NPS was moderate (-0.42), whereas correlations with ISI (-0.24), HAD-anxiety (-0.25), and HAD-depression (-0.22) were weak. CONCLUSION: The cross-cultural adaptation process of PRISM was successful and the adapted version offers reliable and valid psychometric properties in the Brazilian context.

Comparação Transcultural , Autoavaliação Diagnóstica , Dor Facial/diagnóstico , Testes Psicológicos , Adulto , Brasil , Estudos Transversais , Dor Facial/psicologia , Feminino , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Medição da Dor , Fotografação , Estudos Prospectivos , Psicometria , Qualidade de Vida , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Estresse Psicológico
J Pain ; 7(12): 929-36, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17157779


UNLABELLED: The aim of this study was to further validate our carrageenan-induced temporomandibular joint (TMJ) inflammatory hyperalgesia model in rats by showing that administration of indomethacin before the initiation of inflammation would diminish the TMJ hyperalgesia. Using this model, we investigated whether norepinephrine and local beta-adrenoceptors contribute to the development of inflammatory TMJ hyperalgesia. Carrageenan-induced TMJ hyperalgesia was assessed by measuring the behavioral nociceptive responses, such as rubbing the orofacial region and flinching the head, induced by the injection of a low dose of 5-hydroxytryptamine into the TMJ sensitized 1 h before by a TMJ injection of carrageenan. Blockade of prostaglandin synthesis by indomethacin prior to initiation of inflammation by carrageenan significantly attenuated the TMJ hyperalgesia. The guanethidine depletion of norepinephrine or the blockade of beta(2)but not the blockade of the beta(1)-adrenoceptor by the selective adrenoceptor antagonists ICI 118.55 and atenolol, respectively, significantly reduced carrageenan-induced TMJ hyperalgesia. In the present study, we further validated our carrageenan-induced TMJ hyperalgesia model to study the mechanisms involved in inflammatory TMJ hyperalgesia and to test the analgesic effect of different types of peripheral analgesics. We also demonstrated that norepinephrine released at the site of injury contributes to the development of the inflammatory TMJ hyperalgesia by the activation of beta(2)-adrenoceptors. PERSPECTIVE: The findings that local sympathomimetic amines contribute to the inflammatory TMJ hyperalgesia by activating beta(2)-adrenoceptors may be relevant to clinical TMJ inflammatory pain states less sensitive to nonsteroidal anti-inflammatory drugs.

Dor Facial/fisiopatologia , Sistema Nervoso Simpático/fisiopatologia , Transtornos da Articulação Temporomandibular/fisiopatologia , Antagonistas Adrenérgicos beta/uso terapêutico , Animais , Anti-Inflamatórios não Esteroides/uso terapêutico , Carragenina , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Interações Medicamentosas , Dor Facial/induzido quimicamente , Dor Facial/tratamento farmacológico , Lateralidade Funcional , Indometacina/uso terapêutico , Masculino , Medição da Dor/métodos , Limiar da Dor/efeitos dos fármacos , Limiar da Dor/fisiologia , Ratos , Ratos Wistar , Tempo de Reação/efeitos dos fármacos , Serotonina/uso terapêutico , Sistema Nervoso Simpático/efeitos dos fármacos , Transtornos da Articulação Temporomandibular/induzido quimicamente , Transtornos da Articulação Temporomandibular/tratamento farmacológico