Variação da temperatura superficial dos músculos masseter e temporal anterior durante o apertamento dental voluntário com placas interoclusais maxilares de duas diferentes espessuras

Muscle activity has been studied indirectly through analyses of temperature variation in skin surface temperature on the masticatory muscles. These procedure may be an important tool for clinical evaluation and assessment of the evolution of temporomandibular disorders, as well as monitoring the adopted protocol. Thus, its utilization for identified pathological alterations on blood circulation and/or on metabolic activity in subcutaneous tissues, such as the masticatory muscles, is justified. The aim of this study was to investigate the effect of occlusal splints’ thickness on the variation of surface temperature of the anterior temporal and masseter muscles during rest and clenching. It were analyzed 20 symptomatic subjects (10 males and 10 females) selected through the Research Diagnostic Criteria (RDC) questionnaire. Temperature expressed in degrees Celsius (ºC) was measured on the surface of both muscles measured with the aid of a digital thermometer with an infrared radiation reading system. The surface temperature of the anterior temporal and masseter muscles presented significant reduction during teeth clenching in relation to the mandibular rest position. However, there were no significant differences between conditions with and without occlusal splint or between the different thicknesses of splints analyzed. Masticatory muscles showed a considerable similar behavior for both sides, and no significant distinctions were observed between male and female patients.

Distal extension removable partial denture with resilient attachment connect to an anterior fixed implant-supported prosthesis: a clinical report

Background: Considering the limited qualitative and quantitative bone in the posterior arch, this modality of prosthetic treatment could provide a positive emotional factor reestablished by immovability of the anterior fixed implant-supported segment. Objective: This clinical report demonstrates the possibility of achieving positive results with a removable partial denture connected to an implant-supported fixed prosthesis associated to an extra resilient attachment. Clinical significance: In cases of posterior mandibular and maxilla atrophy added to the patients desire against the bone graft, this kind of prosthetic treatment has an important place as an alternative.

Tratamento tardio de traumatismo dentário anterior pela técnica de apicificação

Introdução: paciente do sexo masculino, 37 anos de idade. Após a anamnese, foi constatado que o dente 11 apresentava abertura coronária e presença de hidróxido de cálcio com histórico de trauma dentário nesse dente. Radiograficamente, o dente 11 apresentava formação radicular incompleta, paredes dentinárias finas e frágeis, com divergência foraminal associada a imagem radiolúcida periapical. Objetivo: relatar um caso clínico de apicificação, realizado com trocas de curativo de hidróxido de cálcio. Métodos: o tratamento de escolha foi a apicificação, a qual teve início na segunda sessão, após 15 dias, por meio de desbridamento químico-mecânico de todo o canal radicular, com limas tipo K e irrigação com uma solução de hipoclorito de sódio a 2,5%. Em seguida, pasta de hidróxido de cálcio (hidróxido de cálcio, iodofórmio e propilenoglicol) foi aplicada e trocada de 15 em 15 dias, durante 4 meses. O exame radiográfico foi novamente realizado e demonstrou o fechamento completo da abertura foraminal e regressão da radiolucência periapical. O canal radicular foi obturado utilizando-se um cone confeccionado a partir da união de três cones #60 e pela técnica de condensação lateral com Sealapex. Resultados: seis meses após a obturação, exames revelaram tecidos periapicais normais e ausência de sintomas. Conclusão: concluiu-se que o tratamento do traumatismo dentário associado à necrose do tecido pulpar e à lesão periapical, com trocas sucessivas de pasta de hidróxido de cálcio, foi adequado para se obter a regressão da lesão periapical, formação de barreira mineralizada e promoção de saúde ao paciente.

Diagnostic accuracy of the EMG parameters associated with anterior knee pain in the diagnosis of patellofemoral pain syndrome

Objective To assess the diagnostic accuracy of the surface electromyography (sEMG) parameters associated with referred anterior knee pain in diagnosing patellofemoral pain syndrome (PFPS). Design Sensitivity and specificity analysis. Setting Physical rehabilitation center and laboratory of biomechanics and motor control. Participants Pain-free subjects (n=29) and participants with PFPS (n=22) selected by convenience. Interventions Not applicable. Main Outcome Measure The diagnostic accuracy was calculated for sEMG parameters’ reliability, precision, and ability to differentiate participants with and without PFPS. The selected sEMG parameter associated with anterior knee pain was considered as an index test and was compared with the reference standard for the diagnosis of PFPS. Intraclass correlation coefficient, SEM, independent t tests, sensitivity, specificity, negative and positive likelihood ratios, and negative and positive predictive values were used for the statistical analysis. Results The medium-frequency band (B2) parameter was reliable (intraclass correlation coefficient=.80–.90), precise (SEM=2.71–3.87 normalized unit), and able to differentiate participants with and without PFPS (P<.05). The association of B2 with anterior knee pain showed positive diagnostic accuracy values (specificity, .87; sensitivity, .70; negative likelihood ratio, .33; positive likelihood ratio, 5.63; negative predictive value, .72; and positive predictive value, .86). Conclusions The results provide evidence to support the use of EMG signals (B2 – frequency band of 45–96Hz) of the vastus lateralis and vastus medialis muscles with referred anterior knee pain in the diagnosis of PFPS.