Renata Cunha Matheus Rodrigues Garcia

Signs and symptoms of temporomandibular disorders in adolescents

The aim of this study was to verify the prevalence of signs and symptoms of temporomandibular disorders (TMD) in adolescents and its relationship to gender. The sample comprised 217 subjects, aged 12 to 18. The subjective symptoms and clinical signs of TMD were evaluated, using, respectively, a self-report questionnaire and the Craniomandibular Index, which has 2 subscales; the Dysfunction Index and the Palpation Index. The results of muscle tenderness showed great variability (0.9-32.25%). In relation to the temporomandibular joint, tenderness of the superior, dorsal and lateral condyle regions occurred in 10.6%, 10.6% and 7.83%, respectively, of the sample. Joint sound during opening was present in 19.8% of the sample and during closing in 14.7%. The most prevalent symptoms were joint sounds (26.72%) and headache (21.65%). There was no statistical difference between genders (p > 0.05), except for the tenderness of the lateral pterygoid muscles, which presented more prevalence in girls. In conclusion, clinical signs and symptoms of TMD can occur in adolescents; however, gender influence was not perceived.

Effect of a denture cleanser on weight, surface roughness, and tensile bond strength of two resilient denture liners

STATEMENT OF PROBLEM Denture cleansers used in clinical practice can damage resilient denture lining materials. PURPOSE This study evaluated the effects of a denture cleanser on weight change, roughness, and tensile bond strength on 2 denture resilient lining materials. MATERIAL AND METHODS Forty specimens of microwave acrylic resin (Onda-Cryl), 30 mm in diameter and 4 mm thick, were prepared to verify weight change and surface roughness. The specimens were divided into 4 groups consisting of 10 specimens each, relined with a resilient liner (Coe Soft or Dentusoft), and treated (Polident or tap water). To evaluate tensile bond strength, 12 specimens were used for each group. All specimens were stored in artificial saliva for 15 days, immersed once a day in Polident or tap water, and evaluated at 0 hours and after 24 hours and 7 and 15 days. Roughness was evaluated by use of a profilometer. Weight changes were recorded in milligrams and expressed as the percentage of weight difference between the periods of evaluation. Tensile bond strength was determined with a universal testing machine. The specimens were placed under tension until failure by a cross-speed of 5 mm/min with a 500 Kg load cell. The type of failure was determined by use of stereoscopic microscopy at original magnification x8. The data were submitted to analysis of variance and compared by Tukeys test (alpha=.05). RESULTS Specimens immersed in Polident showed higher and significant (P<.05) weight changes (%) than those immersed in water between 24 hours and 7 days (Coe Soft-Polident: 0.48 +/- 0.09; Coe Soft-water: 0.28 +/- 0.09; Dentusoft-Polident: 0.44 +/- 0.16; Dentusoft-water: 0.22 +/- 0.15) and between 7 and 15 days (Coe Soft-Polident: 0.08 +/- 0.04; Coe Soft-water: -0.17 +/- 0.05; Dentusoft-Polident: 0.01 +/- 0.04; Dentusoft-water: - 0.24 +/- 0.03). There was significant difference (P<.05) in roughness (in micrometers), between treatments after 7 days (Coe Soft-water: 4.07 +/- 0.22; Coe Soft-Polident: 3.36 +/- 0.52; Dentusoft-water: 3.68 +/- 0.72; Dentusoft-Polident: 3.26 +/- 0.41) and 15 days (Coe Soft-water: 4.88 +/- 0.29; Coe Soft-Polident:3.53 +/- 0.61; Dentusoft-water: 4.42 +/- 1.12; Dentusoft-Polident: 3.68 +/- 0.37). Tensile bond strength was highest (P<.05) after 15 days (Coe Soft-water: 5.19 +/- 0.93; Coe Soft-Polident: 4.40 +/- 0.38; Dentusoft-water: 4.42 +/- 1.15; Dentusoft-Polident: 4.84 +/- 1.14). Most failures were cohesive (Coe Soft: 76.04% and Dentusoft: 82.29%). CONCLUSION Within the limitations of this in vitro study, specimens immersed in Polident demonstrated increased weight changes of resilient liners when compared with tap water, but surface roughness and tensile bond strength were unaffected.

Oral health of the elderly with Alzheimer's disease

OBJECTIVE The objective of this study was to describe the oral health of elderly people diagnosed with Alzheimers disease (AD). STUDY DESIGN Thirty elderly subjects with AD (mild, moderate, and severe) and 30 without AD (controls) were included in the study. Volunteer-reported oral health data were collected using the General Oral Health Assessment Index (GOHAI). Demographic and oral characteristics were assessed, including the number of natural teeth; number of decayed, missing, and filled teeth (DMTF); oral health index (OHI); removable prosthesis conditions; and oral pathologies. RESULTS GOHAI values were similar for both groups. Compared with the controls, the subjects with AD had a higher age, DMTF, OHI, and number of oral pathologies and a lower educational level and number of natural teeth. CONCLUSIONS Elderly subjects with AD had poorer oral health than those without the disease. Despite the positive self-perception of their oral health, the oral health of subjects with AD tended to decline as their disease progressed.

Prevalence of bruxism and emotional stress and the association between them in Brazilian police officers

This study aimed to assess the prevalence of bruxism and emotional stress in Brazilian police officers, due to exposure to stressful situations, and to assess the relationship between the type of work done by a police officer and the presence of bruxism and emotional stress. A cross-sectional study was conducted at the Military Police of the State of São Paulo, Campinas, SP, Brazil. The final sample included 394 male police officers (mean age = 35.5 years). Bruxism was diagnosed by the presence of aligned dental wear facets associated with the presence of one of the following signs or symptoms: self-report of tooth-grinding, painful sensitivity of the masseter and temporal muscles, discomfort in the jaw musculature upon waking. The Stress Symptoms Inventory (SSI) was applied to evaluate emotional stress. The type of work done by the police was classified as organizational or operational, the latter being assumed as the more stressful since it exposes the police officer to life risk. The results showed a prevalence of bruxism of 50.2% and a prevalence of emotional stress of 45.7%. The Chi-square test indicated an association between stress and bruxism (P < .05). No significant association was found between emotional stress and type of work (P = .382) or between bruxism and work activity (P = .611). It could be concluded that emotional stress was associated with bruxism, independently of the type of work done by police officers.

Correlation of mastication and masticatory movements and effect of chewing side preference.

The aims of this study were to correlate masticatory performance with mandibular movements during mastication, and to evaluate masticatory performance and mandibular movements of subjects with different types of mastication. Seventy-eight healthy dentate subjects were selected and divided into 2 groups: bilateral and unilateral chewers. This classification was set by using kinesiography during mastication of an artificial material. Unilateral mastication was defined as the majority of the cycles took place at one specific side. The same tracings used to define type of mastication were used to evaluate mandibular movements by means of its parameters. Masticatory performance was analyzed by comminution of the artificial material and a sieving method. Statistical analysis was performed by Spearmans correlation method, and Mann-Whitney and Students t-test, when appropriate, at 5% significance level. No correlation was found between masticatory performance and parameters of mandibular movement during mastication. Bilateral chewers presented significantly better (p<0.05) masticatory performance than unilateral ones, however no differences in parameters of mandibular movement were found between groups. Within the limits of this study, it may be concluded that parameters of jaw movements during mastication are not related to masticatory performance, and that the presence of a preferred chewing side worsens mastication.

Occlusal force, electromyographic activity of masticatory muscles and mandibular flexure of subjects with different facial types

Objective The aim of this study was to evaluate whether vertical facial patterns influence maximal occlusal force (MOF), masticatory muscle electromyographic (EMG) activity, and medial mandibular flexure (MMF). Material and Methods Seventy-eight dentate subjects were divided into 3 groups by Rickettss analysis: brachyfacial, mesofacial and dolychofacial. Maximum occlusal force in the molar region was bilaterally measured with a force transducer. The electromyographic activities of the masseter and anterior temporal muscles were recorded during maximal voluntary clenching. Medial mandibular flexure was calculated by subtracting the intermolar distance of maximum opening or protrusion from the distance in the rest position. The data were analyzed using ANOVA followed by Tukeys HSD test. The significance level was set at 5%. Results Data on maximum occlusal force showed that shorter faces had higher occlusal forces (P<0.0001). Brachyfacial subjects presented higher levels of masseter electromyographic activity and medial mandibular flexure, followed by the mesofacial and dolychofacial groups. Additionally, dolychofacial subjects showed significantly lower electromyographic temporalis activities (P<0.05). Conclusion Within the limitations of the study, it may be concluded that maximum occlusal force, masticatory muscle activity and medial mandibular flexure were influenced by the vertical facial pattern.

Chewing side, bite force symmetry, and occlusal contact area of subjects with different facial vertical patterns

Craniofacial dimensions influence oral functions; however, it is not known whether they are associated with function asymmetry. The objective of this study was to evaluate chewing side preference and lateral asymmetry of occlusal contact area and bite force of individuals with different craniofacial patterns. Seventy-eight dentate subjects were divided into 3 groups according to the VERT index as follows: (1) mesofacial, (2) brachyfacial and (3) dolichofacial. Chewing side preference was evaluated using jaw tracking equipment, occlusal contact area was measured by silicon registration of posterior teeth, and bite force was measured unilaterally on molar regions using 2.25 mm-thick sensors. Statistical analysis was performed using ANOVA on Ranks, Students t-test, and Mann-Whitney tests at a 5% significance level. Mesofacial, brachyfacial, and dolichofacial subjects presented more occlusal contact area on the left side. Only dolichofacial subjects showed lateral asymmetry for bite force, presenting higher force on the left side. No statistically significant differences were found for chewing side preference among all groups. Within the limitations of this study, it can be concluded that craniofacial dimensions play a role in asymmetry of bite force. ClinicalTrials.gov ID: NCT01286363.

Polymerization time for a microwave-cured acrylic resin with multiple flasks

This study aimed at establishing the polymerization time of a microwave-cured acrylic resin (AcronTM MC), simultaneously processing 2, 4, and 6 flasks. Required time was measured according to the parameters: monomer release in water, Knoop hardness, and porosity. Samples were made with AcronTM MC in different shapes: rectangular (32 x 10 x 2.5 mm) for monomer release and porosity; and half-disc (30 mm in diameter x 4 mm in height) for Knoop hardness. There were four experimental groups (n = 24 per group): G1) one flask (control); G2) two flasks; G3) four flasks, and G4) six flasks. At first, polymerization protocol was similar for all groups (3 min/450 W). Time was then adjusted for G2, G3, and G4, based on monomer release evaluation in the control group, obtained by spectrophotometer Beckman DU-70, with emitting wave of 206 nm. Knoop hardness test was performed using a Shimadzu HMV 2000 hardness tester, and 10 indentations were performed on each specimens surface. Porosity was assessed after specimens were immersed in black ink and the pores counted in a microscope. Results showed that the complete polymerization of the resin occurred in 4.5 min for two flasks (G2); 8.5 min for four flasks (G3); and 13 min for six flasks (G4), all with 450 W. Statistical analysis revealed that the number of flasks does not interfere with polymerization, Knoop hardness, and porosity of the resin. Results showed that polymerization of microwave-curing resin with more than one flask is a viable procedure, as long as polymerization time is adjusted.

Implant retainers for free-end removable partial dentures affect mastication and nutrient intake.

OBJECTIVES This study measured swallowing threshold parameters and nutrient intake in partially dentate subjects rehabilitated by conventional free-end removable partial dentures (RPD) and by RPD over posterior implant retainers and ball attachments (BA). MATERIALS AND METHODS Eight subjects (two men and six women; mean age 60.1 ± 6.6 years old) received conventional total maxillary dentures and free-end RPD in the mandible. Two months after denture insertion, swallowing threshold and nutrient intake assessments occurred, which included an evaluation of the number of masticatory cycles and medium particle size (X₅₀) of a silicone test material (Optocal). A 3-day food diary verified nutrient intake based on a standard Brazilian Food Composition Table. Then, osseointegrated implants were placed bilaterally in the mandibular first molar region, followed by BA, which was fitted in the RPD bases after healing. After 2 months of the RPD over implants and BA use, variables were again assessed. Wilcoxon signed rank tests evaluated the data (P < 0.05). RESULTS Masticatory cycles did not differ (P > 0.05); however, subjects showed decreased X₅₀ values at the swallowing moment (P = 0.008) and increased daily energy (P = 0.008), carbohydrate (P = 0.016), protein (P = 0.023), calcium (P = 0.008), fiber (P = 0.016), and iron (P = 0.016) intake with RPD implants and BA inserts. No differences were found in fat consumption (P > 0.05). CONCLUSION Implants and BA retainers over a free-end RPD resulted in smaller swallowed median particle size and improved nutrient intake.

IMPLANT RETENTION AND SUPPORT FOR DISTAL EXTENSION PARTIAL REMOVABLE DENTAL PROSTHESES: SATISFACTION OUTCOMES

STATEMENT OF PROBLEM The rotational movements of the distal extension denture base of partial removable dental prostheses frequently harm the prosthesis stability, leading to discomfort during function. PURPOSE This study evaluated the use of distal implants to retain and support partial removable dental prostheses and assessed the outcomes with respect to specific aspects of patient satisfaction. MATERIAL AND METHODS Twelve participants (mean age, 62.6 ± 7.8 years) received new conventional mandibular partial removable dental prostheses and complete maxillary dentures. After 2 months of conventional prosthesis use, the participants completed a questionnaire assessing their satisfaction. Implants were then inserted bilaterally in the mandibular posterior region and, after 4 months, ball attachments were placed on the implants and on the partial removable dental prosthesis acrylic resin base. The implants and remaining teeth were followed up with clinical and image examinations. After 2 months, satisfaction was reevaluated, and the data were analyzed by the paired Student t test and the Bonferroni correction (α=.05). RESULTS Clinical evaluation found stable periodontal conditions around the implants, no intrusions or mobility of teeth, and no radiographic changes in bone level. Participants reported significant improvements (P<.05) in retention, comfort, masticatory capacity, and speaking ability after implant placement. CONCLUSIONS Implant-retained and -supported removable prostheses improve retention and stability, minimize rotational movements, and significantly increase participant satisfaction.