Patrícia dos Santos Calderon

Primary headaches interfere with the efficacy of temporomandibular disorders management

OBJECTIVES: This cross-sectional study aimed to evaluate the influence of Primary Headache (PH) on efficacy of a Temporomandibular Disorders (TMD) conservative therapy and its association with the presence of self-reported parafunctional habits. SAMPLE AND METHODS: Sample was composed of 400 medical records, divided into four groups: I) Muscular TMD (n=64); II) Muscular TMD+PH (n=48); III) Muscular TMD+Articular TMD (n=173); IV) Muscular TMD+Articular TMD+PH (n=115). All groups had undergone a TMD therapy for three months with a stabilization appliance and counseling for habits and behavioral changes, with no specific headache management. Current pain intensity and existence or not of self-reported bruxism were assessed. Repeated measures ANOVA and Chi-Square test followed by Odds were used for statistical analysis, with a significance level of 5%. RESULTS: results of this study showed that: (1) A conservative therapy with stabilization appliance and counseling for habits and behavioral changes was effective in the TMD pain relief; (2) Groups with an additional diagnosis of PH had worsened the pain improvement significantly; and (3) no association between the presence of self-reported bruxism and PH was found. CONCLUSIONS: this study could elucidate the important effect that headache may have on the TMD management.

Do matrix metalloproteinases play a role in degenerative disease of temporomandibular joint? A systematic review.

Objective: To evaluate whether the high expression of metalloproteinases observed in the temporomandibular joint can be considered as an indicator of degenerative disease. Methods: The PubMed, BVS, Embase, and ScienceDirect databases were systematically searched for articles written in English, regarding human studies that were published from 2003 to 2013. After applying the exclusion and inclusion criteria, four articles were selected. Results: Two studies analyzed the presence of matrix metalloproteinases (MMPs) through histology and immunohistochemical evaluation of articular discs; both observed a higher concentration of MMPs in the discs of ill patients. Another study, using genomic DNA from oral cells of ill and healthy patients, found a higher presence of MMP-1G/2G in affected individuals. A fourth study examined the synovial fluid of patients and control groups and concluded that MMPs were present in most patients with articular changes. Discussion: Despite the lack of methodology standardization,...

Impact of mandibular conventional denture and overdenture on quality of life and masticatory efficiency.

The aim of this non-randomized controlled clinical trial was to evaluate the oral health-related quality of life and masticatory efficiency of patients rehabilitated with mandibular two-implant overdentures with immediate loading or conventional dentures. Fifty completely edentulous patients wearing bimaxillary conventional dentures, for at least one year, were recruited. The patients were then assigned to either two treatment groups: mandibular overdentures supported by two implants with bar-clip system and a maxillary conventional denture (n = 25), and new maxillary and mandibular conventional complete dentures (n = 25). Masticatory efficiency and oral health-related quality of life were assessed before and 3 months after denture insertion. The Brazilian version of OHIP-Edent questionnaire was used to assess the oral health-related quality of life. Masticatory efficiency was evaluated with chewing capsules through a colorimetric method. The results revealed fewer oral health-related quality of life problems in patients wearing mandibular two-implant overdentures compared to the conventional dentures group. In addition, the implant overdenture group presented statistically significant improvement in masticatory efficiency (p = 0.001). There was no correlation between masticatory efficiency and OHIP in the implant group (p > 0.05), however a correlation was found in the conventional denture group (p < 0.05). Therefore, these short-term results suggest that mandibular overdenture retained by 2 implants with immediate loading combined with maxillary conventional dentures provide better masticatory efficiency and oral health-related quality of life than mandibular conventional dentures.

Caracterização tomográfica das áreas edêntulas previamente à reabilitação com implantes unitários

O objetivo deste estudo foi caracterizar as areas edentulas de pacientes que serao reabilitados com um implante dentario osseointegrado unitario em regiao este-tica da maxila por meio das tomografias computadorizadas. Os parâmetros avalia-dos em 14 tomografias foram: distância da Juncao Cemento-Esmalte (JCE) ate a crista ossea (CO), distância entre as CO e distância entre as coroas dentarias dos dentes adjacentes ao espaco protetico (EP), largura e altura ossea do EP, espessu-ra do palato na regiao dos segundos pre-molares e dos molares bem como a espes-sura vertical do tecido mole na regiao do EP. Os resultados foram analisados por meio de estatistica descritiva e teste de Correlacao de Spearman utilizando nivel de significância de 5%. A distribuicao dos dentes avaliados foi de 35,7 % para dentes anteriores e 64,3 % para dentes posteriores. Valores baixos e medios para o coefici-ente de correlacao (≤ 0.29 e ≥ 0.30 ≤ 0.49, respectivamente) e sem diferencas esta-tisticas significativas foram encontrados na maioria das comparacoes, indicando fra-cas correlacoes. Apenas para a correlacao espessura da mucosa do EP versus dis-tância entre JCE e CO no dente mesial ao EP foi encontrado diferenca estatistica significativa (p= 0.03) e correlacao moderada (r = 0.56). A tomografia computadori-zada de feixe conico e uma ferramenta viavel para a regiao maxilofacial pois permitiu a mensuracao de diversos parâmetros de tecido mole e duro da cavidades bucal uteis para o planejamento com implantes dentarios, aumentando a previsibilidade de sucesso dos tratamentos reabilitadores.

Does TGF-β play a role in degenerative temporomandibular joint diseases? A systematic review.

Objectives: The objective of this review was to assess the literature for evidence investigating the role of TGF-β in temporomandibular joint disease with osteoarthritis. Method: An electronic and manual search was carried out on the databases, MEDLINE/PubMed, Cochrane Library, Web Of Science, and EMBASE, from 1975 to December 2015 by two independent evaluators to identify clinical and laboratory trials in English. Results: The search produced 693 records. Following a process of selection based on certain criteria, eight articles were included. Discussion: This systematic review suggests that TGF-β administration alone does not result in joint regeneration; other factors may be involved, such as TGF-β receptor expression ,and TGF-β receptor mutations that do not allow a correct transduction, resulting in TGF-β deficiency. The anabolism induced by this growth factor is also able to neutralize the catabolic processes that are elevated in osteoarthritis. Therefore, further studies are essential to determine how the concentration of TGF-β in the temporomandibular joints acts as a potential marker for the development of degenerative conditions.

Satisfaction and Fibromucosa Integrity in Patients Wearing Mandibular Kennedy Class I RPDs

Introduction: The association between the patient’s satisfaction and the occurrence of ulcers is important for treatment predictability. The aim of this study was to evaluate the satisfaction level, fibromucosa integrity and relation between these two factors in patients wearing mandibular Kennedy Class I removable partial dentures (RPD) and maxillary complete dentures at the Dental Department of Federal University of Rio Grande do Norte (UFRN). Materials and Methods: The satisfaction of 52 patients was evaluated based on a questionnaire about current prostheses, reasons for dissatisfaction, personal opinions about the prostheses, function and period 6 months to 1 year after insertion of denture wearing. The fibromucosa integrity was based on the occurrence of ulcers after 24 hours; 7, 15, 30 and 60 days, and 6 months. Results: A total of 90.4% of the patients (n=47) wore RPDs. Most of the patients (75%, n=39) reported satisfaction with RPDs; functional problems were the main reason for dissatisfaction (21.2%, n=11). The occurrence of ulcers decreased over time. The ulcers were usually located in the region of fornix. Patients were classified into Class III and IV according to the PDI classification. Fisher’s exact test was used to assess any association between satisfaction and fibromucosa integrity and no significant difference was found (p=0.275). Conclusions: The patients reported appropriate satisfaction with the Kennedy Class I RPDs after 6 months and 1 year. There was no association between patients’ satisfaction and fibromucosa integrity.