Antonio Sergio Guimarães

Frequency of temporomandibular disorder signs in individuals with cerebral palsy.

This study aimed to determine the frequency of temporomandibular disorder (TMD) signs in 68 individuals with cerebral palsy, aged between 3 and 23 years. TMD signs were evaluated according to the Research Diagnostic Criteria to assess temporomandibular joint sounds, lateral jaw deviation during opening and closing movements and limitation of maximum mouth opening (>40 mm). The frequency of TMD signs observed in the cerebral palsy group (46/68-67.6%) was higher than in the control group (17/68-25%). The clinical scenario of CP seems to make these individuals more prone to the development of TMD signs.

Functional unilateral posterior crossbite effects on mastication movements using axiography.

This prospective study investigated the influence of functional unilateral posterior crossbite on mastication movements. The study group included 16 patients (nine girls and seven boys) with functional unilateral posterior crossbite involving three or more posterior teeth. A control group comprised 15 individuals (nine girls and six boys) with normal occlusion and the mean age of both groups was 9.17 years. The mandibular masticatory movements were registered, using computer axiography, for 30 seconds during chewing to determine the preference side of chewing. The patterns of the first, third, and fifth chewing cycles were compared with the preference side to establish whether they would predict the chewing preference side. The extent of the maximal lateral and vertical displacements of the mandible during chewing were compared between study and control groups. This study found that overall the left side was the preferred mastication side in 43.7% of individuals in the study and 46.7% in the control group. There was no relationship between the side of the crossbite and the masticatory preference side (Mc Nemar test, P = .5). No correlation was present between the patterns of chewing movements in the first, third, or fifth cycles. Both study and control groups showed similar maximal lateral and vertical mandible displacement.

Focal dermal hypoplasia: a case report and literature review

Focal dermal hypoplasia (FDH), also known as Goltz-Gorlin syndrome, is an autosomal dominant disease affecting tissues derived from the ectoderm and mesoderm. Knowledge and early diagnosis of the craniofacial alterations commonly found in patients with FDH provide oral health care professionals with effective preventive and therapeutic tools. This article aims to review the craniofacial characteristics present in FDH and the main systemic manifestations that have implications for dental management, while presenting a new case of the syndrome with novel oral findings.

Prevalence of the Third Head of the Lateral Pterygoid Muscle: A Magnetic Resonance Image Study

SUMMARY: The lateral pterygoid muscle (LPM) is important in the physiology and dysfunction of the temporomandibularjoint (TMJ), which has described the presence of a third head in the lateral pterygoid muscle (THLPM). The purpose of this stud y was toevaluate the prevalence of THLPM and its relationship with the TMJ disc through magnetic resonance imaging (MRI). It was evalua ted178 MRI of the TMJ of healthy individuals, in images that presented THLPM, and these were defined and measured at the surfaceinserted into the disc. The prevalence of THLPM was 20.22% (n = 36). Insertion of THLPM was made entirely on the TMJ disc, theaverage area of insertion was 4.14mm (SD 1.35) in women and 4.67 (SD 2.68) in men, but these differences were not significant. Weconcluded that the LPM has a complex structure, and that a THLPM could contribute in the development of TMJ disc function alter ationsand anterior disc displacement. KEY WORDS: Lateral pterygoid muscle; Temporomandibular joint; Articular disc; Temporomandibular dysfunction.

Dor miofascial dos músculos da mastigação e toxina botulínica

JUSTIFICATIVA E OBJETIVOS: Disfuncao temporomandibular (DTM) abrange um conjunto de alteracoes craniofaciais, que pode envolver a articulacao temporomandibular (ATM), os musculos da mastigacao e/ou estruturas associadas. As DTM musculares sao as mais frequentes e um dos seus subtipos compreende a dor miofascial. A toxina botulinica tipo A (BoNT A), tem sido objeto de estudos no controle da dor, incluindo dor miofascial, e esta relacionada ao mecanismo de alivio da dor, nao somente nos receptores da juncao neuromuscular. O objetivo deste estudo foi acessar os artigos que abordam o uso da BoNT A no tratamento da dor miofascial nos musculos da mastigacao. CONTEUDO: Foi realizada uma busca nas bases de dados Pubmed, LILACS e BVS, de 2000 a abril de 2012, cruzando-se os descritores: toxinas botulinicas tipo A, sindromes da dor miofascial, dor facial, sindrome da disfuncao da articulacao temporomandibular, pontos-gatilho, bruxismo, articulacao temporomandibular, musculo masseter e musculo temporal. Como criterios de inclusao foram analisados estudos randomizados, duplamente encobertos ou encobertos, com 10 ou mais participantes, de aspectos metodologicos aleatorios, que relacionassem o uso da toxina botulinica na dor miofascial da DTM nos musculos da mastigacao, mais especificamente masseter e temporal, limitados para o idioma ingles encontrando-se seis estudos que foram incluidos neste estudo. CONCLUSAO: O uso da BoNT A nao se mostrou mais eficiente no tratamento da dor miofascial do que os tratamentos convencionais ja estabelecidos. Por existirem diversas variaveis nao controladas nos poucos estudos pertinentes, mais estudos, com metodologias criteriosas, sao necessarios para viabilizar sua aplicacao em pacientes refratarios a dor submetidos previamente a tratamentos conservadores.

Prospective study of a group of pre-university students evaluating anxiety and depression relationships with temporomandibular disorders.

Objectives: The aim of this prospective longitudinal study was to evaluate the relationships between anxiety, depression, and temporomandibular disorders (TMD) in a sample of pre-university students submitted to a stressful event. Study Design: 153 students from a pre-university course (82 females and 71 males between 16 and 31 years old) were given a survey about TMD symptoms and a survey about anxiety and depression scale at the beginning and the end of the preparatory course (August 2009-T1, and November 2009-T2). Results: Results were analyzed using a chi-square test and Odds Ratio (OR), significance level of α = 0.05. Statistical significance were found to depression rates in students with TMD (16% on T1 and 26% on T2, p = 0.001) as well as in general sample (12% on T1 and 22% on T2, p = 0.009), anxiety and TMD symptoms presented constant rates in both periods. Increased risk of having TMD were found in participants with anxiety (OR 2.6 in T2 and 5.6 in T1) and depression (2.0 in T2 and 3.3 in T1), but only anxiety reach statistical significance in both periods. Conclusions: TMD symptoms were a fluctuating variable that exchange between some individuals of this study. Independently of the TMD, depression rates significant increased in the evaluated period. Finally, anxiety was the psychological symptom related to the increased risk of having TMD. Key words:Temporomandibular disorders, anxiety, depression, orofacial pain, hospital anxiety and depression scale.

Anatomic and dynamic aspects of stomatognathic structures in osteogenesis imperfecta: a case report.

Abstract The osteogenesis imperfecta congenita (OMIM 166210) type II phenotype can be caused by mutation in either the COL1A1 gene or the COL1A2 gene that encode the chains of type I procollagen, the major protein in bones. Patients can therefore present a combination of features, including multiple long bone fractures and deformities, growth deficiency, joint laxity, hearing loss, blue sclera, and dentinogenesis imperfecta. The purpose of this study is to describe a clinical case of this syndrome, focusing on the anatomy of the temporomandibular joint (TMJ) that was assessed using computed tomography (CT) method. Clinical examination included evaluation of mandibular dynamics and investigation of temporomandibular dysfunction (TMD).

Superior Head of the Lateral Pterygoid Muscle Inserting in Asymptomatic Temporomandibular Joints

5.7-5.5mm (SD 1.5-1.3), corresponding to 69.8-70.7% of the SHLP. In men, the average insertion into the disc was between 6.2-6.12mm (SD 1.8-1.9), or 68.9-74.2%. There were no differences in terms of the sex of the patients or the side of the joint. We found a significant percentage of SHLP fibers embedded in the disc of asymptomatic TMJs, and its role in the anterior disc displacement and the development of the temporomandibular dysfunction should be revised.

Influência do aparelho propulsor Twin Block no crescimento mandibular: revisão sistemática da literatura

OBJECTIVE: to verify the efficiency of the mandibular propulsor orthopedic appliance Twin Block in the mandibular growth. METHODOLOGY: systematic review of literature since 1970. RESULTS AND CONCLUSIONS: the majority of the authors agreed with a significant reduction of the SNA angle with retroclination of the upper incisors, an increase of the SNB angle with proclination of the lower incisors and there was a positive tissue response on the TMJ during the use of the appliance. The alterations were the combination of modifications on the condyle, the mandibular fossa, the basal bone and dentoalveolar alterations. The exact role of the structures depend on a multiplicity of factors in each individual such as morphogenetic pattern, age, gender, functional pattern, control of the appliance and habits, among others.

Evaluation of body painful areas in patients with muscular temporomandibular disorder: a retrospective study

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 Sao 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.