RESUMO
BACKGROUND AND AIM: This review aims at presenting a current view on the most frequent factors involved in the mechanisms causing temporomandibular disorders (TMD). METHOD: We conducted a critical review of the literature for the period January 2000 to December 2014 to identify factors related to TMD development and persistence. RESULTS: The etiology of TMD is multidimensional: biomechanical, neuromuscular, bio-psychosocial and biological factors may contribute to the disorder. Occlusal overloading and parafunctions (bruxism) are frequently involved as biomechanical factors; increased levels of estrogen hormones are considered biological factors affecting the temporo-mandibular-joint. Among bio-psychosocial factors, stress, anxiety or depression, were frequently encountered. CONCLUSIONS: The etiopathogenesis of this condition is poorly understood, therefore TMDs are difficult to diagnose and manage. Early and correct identification of the possible etiologic factors will enable the appropriate treatment scheme application in order to reduce or eliminate TMDs debilitating signs and symptoms.
RESUMO
We revised the charts of first interventions of refractive surgery with LASIK and PRK in order to evaluate the results and to analyze the incidents and complications we encountered as beginners in photorefractive surgery. In total 50 eyes of 29 patients (7 men and 22 women) were operated. 42 eyes were myopic (21 with astigmatism) and 8 eyes were hyperopic (6 with astigmatism). LASIK was performed in 45 cases and PRK in 5 cases all myopias. The intervention was performed with AESCULAP MEDITEC MEL 70G-Scan laser. The follow-up period was between 3 and 12 months. Per total the results were as follows: Average pre-operative non-corrected visual acuity was 0.23 Average pre-operative corrected visual acuity was 0.8 Average post-operative non-corrected visual acuity was 0.74 Average post-operative corrected visual acuity was 0.77 We noted some minor intra-operative incidents: insufficient anesthesia (6%) and some important intra-operative incidents: free cap (6%), flap desepithelization (4%). Minor post-operative complications were: mild corneal edema, corneal desepitelisation (14%), and some severe post-operative complications: corneal ulcer (4%), comeal mycosis (2%), pupilary paresis (2%). Under-correction was present per total in 52% of cases, but mainly in myopias over 10 dpt (30%), as well as induced astigmatism (10%). Major complicated cases were only 5 (10%) and were consecutive to some mechanical problems (vacuum failure, system decentration). An interesting observation is related to IOP evolution. In average a decrease of IOP was noted from pre-operative medium of 14.43 mmHg to a post-operative medium value of 10.73 mmHg.
Assuntos
Ceratomileuse Assistida por Excimer Laser In Situ/efeitos adversos , Ceratectomia Fotorrefrativa/efeitos adversos , Procedimentos Cirúrgicos Refrativos , Adolescente , Adulto , Astigmatismo/cirurgia , Edema da Córnea/etiologia , Úlcera da Córnea/etiologia , Feminino , Seguimentos , Humanos , Hiperopia/cirurgia , Lasers de Excimer , Masculino , Pessoa de Meia-Idade , Miopia/cirurgia , Distúrbios Pupilares/etiologia , Erros de Refração/complicações , Acuidade Visual/fisiologiaRESUMO
Based on some mathematical and statistical approaches, our study leads to some conclusions concerning the procedures related to the orodental prosthetics. Occlusal equilibration in orodental prosthetics is a major issue because besides motivating patients for a regular daily oral hygiene, it could significantly increase the longevity of FPR. More dental hygiene information should be given after prosthetic treatment and patients should be motivated to attend recalls on a regular basis for professional teeth-cleaning. Interdental cleaning aids should be explained and the patients have to be motivated to use them at least once a day and the using technique should be individualized. Regarding the application of the deformable models theory, implemented in the context of an expert type software environment, it is known that the fact that modelling by advanced methods and techniques based on the deformable surfaces theory increases the efficiency of the dentofacial prosthetics procedures is a domain of great interest in the actual medical research.