Alberto Albaladejo Martínez

Electromyographic biofeedback training for reducing muscle pain and tension on masseter and temporal muscles: A pilot study

Background Due to the absence of agreement about an effective unified treatment for temporomandibular disorders, non-invasive therapies such as EMG-biofeedback generate a greater interest. Furthermore, most studies to the present show methodological deficiencies that must be solved in the future, which makes important to emphasize this line of studies. Material and Methods Fourteen patients were selected for this case series study, and replied to a questionnaire concerning awareness of bruxism, painful muscles, and muscle tension. They also practiced an intraoral exploration (occlusal analysis and mandibular dynamics), and an extraoral exploration of the head and neck muscles and the temporomandibular joint. Before each session, patients responded to a questionnaire about the subjective perceived improvement. In each session, a period of three minutes of pre-biofeedback EMG activity of right masseter and temporal muscles was registered, then patients performed 30 iterations of visual EMG-biofeedback training and finally, a period of three minutes of post-EMG activity was also registered for those muscles. Patients performed four sessions. Results A decrease in painful symptoms was found for all patients since the first session. EMG activity decreases (p<0,05) in both muscles during the biofeedback training stage, in the four sessions. It is also observed a decrease (p<0,05) in EMG activity in the masseter muscle at the post-biofeedback stage, in the second and third sessions. There is likewise a decrease in EMG post-biofeedback activity of the temporal muscle (p<0,05) in sessions two, three, and four. Conclusions EMG-biofeedback training produces a decrease in EMG activity in both masseter and temporal muscles during the session. This decrease persists during the post-biofeedback period since the second session. Also there is a decrease in painful symptoms for all patients. Key words:Muscle tension, muscle pain, EMG-biofeedback, masseter muscle, temporal muscle.

Actualización de la validez de los métodos digitales de trazado cefalométrico en 2 dimensiones

Resumen Objetivo Presentar los metodos que se emplean para estudiar la fiabilidad y validez de la cefalometria en 2 dimensiones, los programas y sistemas evaluados, y exponer las medidas y puntos cefalometricos mas conflictivos. Material y metodos Se realizo una revision bibliografica de los estudios publicados sobre trazado digital. Veintiocho articulos cumplieron con los requisitos del estudio, abarcando desde 1981 a 2011. Los elementos estudiados en los articulos son los trazados sobre distintos medios en 2 dimensiones (pelicula radiografica, impresion de copia digital, digitalizador, programas informaticos). Resultados El trazado cefalometrico sobre pelicula radiografica muestra los mejores resultados. La radiografia digital obtenida de telerradiografos digitales actuales o el escaneado en alta resolucion de la pelicula radiografica obtienen los valores mas cercanos al trazado manual, pero fotografiar digitalmente la pelicula presenta diferencias significativas. Conclusiones Los programas informaticos mas modernos son fiables para el estudio cefalometrico en el ambito clinico, y conforme evolucionan recortan diferencias presentes en estudios realizados con programas mas antiguos.

Fístula Cutánea de Origen Dental

Cutaneous Fistula of Dental origin Orofacial cutaneous fistulas are often misdiagnosed as dermatological lesions without tak ing into account their relationship with dental disease. This leads to mistaken and unnecessary treatment for the patient., whose problem remains unresolved, and delays the endodontic therapy which will eliminate the dental infection and subsequent closure and scarring of the extraoral fistula. Accordingly, whenever this type of fistula occurs the physician should look for a dental cause and thus make an early diagnosis and refer the patient to his/her dentist so that treatment of the pulp canals can be performed.