Using Conservative Condylectomy for Management of a Large Osteochondroma of the Mandibular Condyle With 6-Year Follow- up

Osteochondroma is a hamartomatous proliferation of cartilaginous tissue, which is the most common benign tumor of the long bones, but is relatively rare in the maxillofacial region. Most cases of mandibular condylar osteochondroma manifest with facial asymmetry or malocclusion with limited temporomandibular joint movements. Several approaches for management of this lesion have been proposed, as conservative condylectomy technique. This procedure has been suggested a valid approach to minimize facial asymmetry, contributing to the recovery of occlusion associated with no local tumor recurrence, and without condylar reconstruction procedure. Therefore, this article aims to describe a clinical report of a true osteochondroma of the mandibular condyle in a 35-year-old patient who was successfully treated using conservative condylectomy procedure.

Avaliação da obesidade na prevalência e gravidade das disfunções temporomandibulares

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efectos de los aparatos propulsores mandibulares fijos en la articulación temporomandibular

Fixed mandibular propulsion appliances are an alternative for the treatment of Class II malocclusion in individuals with mandibular deficiency. Since they are fixed appliances, said devices keep the mandible in an anterior-forced position during rest and during all mandibular functions. When a propulsive appliance is used, the lower jaw is displaced forward and downward. This movement leads to a new position of the condyle, which can, ultimately affect the normal functioning of the temporomandibular joint (TMJ). The aim of this paper was to review effects of fixed mandibular propulsive appliance on TMJ. Inclusion criteria considered studies on animals or humans using TMJ radiography, computed tomography, and magnetic resonance imaging. Studies confirm a favorable relation between condyle and glenoid fossa following treatment with fixed mandibular propulsion appliances.

Análise tomográfica da articulação temporomandibular no tratamento com Herbst em adulto jovem

Class II malocclusion features a high prevalence in Brazil, being considered as a routine in orthodontic clinics. A number of appliances are shown in the literature in order to correct Class II malocclusion with mandibular retrusion. Herbst´s fixed functional appliance, idealized by Emil Herbst (1905) and reintroduced, in the 1980´s, by Hans Pancherz is highlighted for maintaining the mandible continuously advanced, showing a shorter active treament time, an immediate esthetic impact on the facial profile, as well as requiring no patient´s commitment. Recent researches indicate the use of this appliance in individuals after pubertal growth surge. The aim of the present study is to show the orthodontics practitioner the option to use this appliance so as to treat Class II in individuals after the growth surge, obtaining satisfactory outcomes and further Class II correction.

Desordens temporomandibulares em usuários de prótese parcial removível: prevalência de acordo com a classificação de Kennedy

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Single puncture for TMJ arthrocentesis: an effective technique for hydraulic distention of the superior joint space

Temporomandibular joint arthrocentesis is a method of flushing out the synovial fluid that is currently performed by providing a double puncture to the upper joint space. The traditional 2-needle technique has some restrictions, such as the difficulty in performing it in the presence of intra-articular adherences and in the female patients, because the space is very small. The adoption of a single-needle for fluid injection might have some advantages with respect to the traditional 2-needle approach in terms of easily, time of execution and tolerability. We describe a single needle technique and we recommend the use.

Acessos cirúrgicos a articulação temporomandibular: revisão de literatura

The choice of surgical approach to diseases that affect the pre-auricular region has been subject of much discussion in the literature. Access pre-hearing, have been used with high compliance rate of success, and during the history of surgery, several modifications were made in this approach with the goal of reducing the irreversible consequences especially regarding common in condylar fractures as paralysis and facial scars. The views range from the indication of surgical treatment for all fractures, until the conviction that no fracture of the bone segment should be surgically treated. Therefore, this study is of relevance, since offers surgeons warn about the care on the anatomical structures involved in these surgical approaches and describe, seeking a comparison between them, the advantages of them by means of a literature review covering from the extensive bouts of Bellinger (1940) and Al-Kayat (1979) that provide a broad view of the surgical field to access modified and increasingly smaller as the endaural (2001) which not only allows a satisfactory field of aesthetics as maintenance the patient without any signs of scarring.

Reabsorção condilar progressiva: revisão de literatura

The progressive condylar resorption is a irreversible complication that can result in malocclusion and facial deformity that can happen especially in postoperative orthognathic surgery of mandibular advancement or combined surgery. Predominantly affect young women, bearers of malocclusions of skeletal class II and with incidence of temporomandibular disorders prior to surgical treatment. Its exact etiology and pathogenesis remain unclear. The purpose of this article is to make a literature review of the last 10 years on the progressive condylar resorption. For this, we used the Medline database for articles in the English language. Then, 13 articles were found, evaluated and compared on predisposing factors, etiology, diagnosis and clinical management.

Abordagem terapêutica nas desordens temporo-mandibulares: técnicas de fisioterapia associadas ao tratamento odontológico

Temporomandibular disorders (TMD) are related to discomfort in the temporomandibular joint (TMJ). These diseases are multifactorial and treatment usually requires a combination of different approaches because each patient presents with different and usually complex needs. It is necessary to know how each expert should plan for a successful treatment.

Doença de Lyme na região de cabeça e pescoço: implicações para a odontologia

Lyme disease (LD) is a systemic inflammatory changes resulting from the direct action of the spirochete Borrelia burgdorferi on the host or indirect damage produced by immune response to this microorganism. This pathogen is transmitted by inoculation in the bloodstream by the tick genus Ixodes and is most commonly found in North America, Europe and Asia. In these regions, the dental community is aware about its commonest clinical symptoms, collaborating with the establishment of a diagnosis. However, in Brazil, the frequent facial or peripheral neurological manifestations, among them the Bell's palsy, ocular disorders, disorders in the temporomandibular joint, as well as paresthesia of upper and lower alveolar nerves are observed. In our country, the diagnosis of Lyme disease is primarily based on clinical symptomatology, but most of cases remain without diagnosis and treatment. Then, the detection of the early manifestations of Lyme disease by health professionals is essential for the proper antibiotic treatment, preventing the progression of the disease, and allowing the establishment of favorable prognostic.

Determinação fenotípica das haptoglobinas em pacientes com dor crônica causadas por desordens temporomandibulares

The phenotypes of the hemoglobin-haptoglobin (HbHp) system were measured in 124 subjects, 100 patients with chronic pain in temporomandibular disorders and 24 normal, without any bodily pain during the years 2000 -2003. The system Hb-Hp showed polymorphism Hp1-1, Hp2-1 and Hp2-2, at 100% and 85% respectively; anahaptoglobinemia (Hp0) in 15% of the sample studied. Hp1-1 genotype was present significantly (p < 0, 0001) in patients with TMDs, regardless the clinical type TMD, suggesting that Hp1-1 and likely genetic marker of susceptibility for the development of chronic pain in TMD.

TMJ Vibrations in Asymptomatic Patients Using Old and New Complete Dentures

Purpose: The aim of this study was to assess the presence of temporomandibular joint (TMJ) noises in subjects with severe bone resorption, who have worn the same complete dentures for over 10 years, and 5 months after treatment with increments of acrylic resin on the occlusal surface after having new dentures in place.Methods: After applying the research diagnostic criteria (RDC)/temporomandibular disorder (TMD) questionnaire, 20 asymptomatic subjects were assessed before and 5 months after the new dentures were put in place. Joint vibrations were assessed by the Sono Pak program by selecting the vibrations that occurred during the opening and closing cycle.Results: The means of the results revealed a nonnormal distribution and were submitted to Kruskal-Wallis statistical analysis (p < 0.05). The vibration means were of low intensity (<= 9.96 Hz). After rehabilitation, there was a reduction in the vibrations (<= 5.2 Hz) statistically significant only at the end of mouth opening with the old dentures when compared with the other cycles.Conclusion: The intensity and number of occurrences of joint vibrations were reduced after 5 months of wearing new dentures.

Surgical and Prosthetic Rehabilitation of Patients With Hemimandibular Defect

Purpose: This work intended to investigate, by means of a literature revision, the techniques and materials used for the rehabilitation of hemimandibular defect patients, prosthetic and occlusal aspects of these patients, and chewing and swallowing.Materials and Methods: For the confection of this revision, we consulted the database indexers Google Scholar, PubMed, and SciELO and found studies published between the periods 1972 and 2008. The terms used for the search had been "to hemimandibular defects," "to temporomandibular joint protheses," and "vascularized cap grafts," which had been searched separately and combined.Conclusions: Diverse techniques and materials used for the reconstruction of hemimandibular defects exist; however, great bone resorption is still observed, which will compromise the prosthetic rehabilitation of these patients. More prospective works and stories of clinical cases duly registered will be able to elucidate in a clearer form the anatomic and functional devolutions of the verbal socket of hemimandibular defect patients.

Mapas de dor corporal aprimoram os relatos das queixas dolorosas em pacientes com dor orofacial

JUSTIFICATIVA E OBJETIVOS: Identificar as queixas dolorosas dos pacientes é essencial para determinar diagnósticos e intervenções terapêuticas adequadas em dor orofacial (DOF). Assim, o objetivo deste estudo foi verificar a frequência das queixas de dor relatadas comparando-as àquelas marcadas pelos pacientes em mapas de dor. MÉTODO: Os dados foram coletados dos prontuários de 532 pacientes da Clínica de Dor Orofacial da Faculdade de Odontologia de Araraquara. Os indivíduos responderam a um questionário informando suas queixas de dor e completaram um mapa corporal indicando as áreas dolorosas. A frequência dos relatos foi comparada à frequência dos locais identificados nos mapas. Foram consideradas nove regiões anatômicas: cabeça, face, pescoço, ombros, braços, tórax, abdômen, costas e pernas. Também foram calculados sensibilidade, especificidade e valores kappa comparando os relatos de dor aos mapas, os últimos considerados padrão-ouro. RESULTADOS: A média etária da amostra foi de 33,5 ± 13,8 anos, 33,9 ± 13,9 anos para as mulheres e 31,7 ± 13,1 anos para os homens. Foi observada maior prevalência de dor entre as mulheres. em ambos os gêneros, as regiões com mais queixas de dor estavam localizadas na parte superior do corpo e uma diferença significativa entre os relatos de dor e os desenhos de dor foi observada para as regiões abaixo do pescoço. Os mapas de dor corporal demonstraram superioridade sobre os relatos de dor na identificação das queixas dolorosas durante a anamnese. CONCLUSÃO: O relato da queixa principal não foi um método eficiente para conhecer todas as queixas dolorosas, pois os mapas corporais evidenciaram a presença de dores adicionais em pacientes com DOF.

Incidence of sleep bruxism among children in Itanhandu, Brazil

Sleep bruxism (SB) in children may be related to headaches and causes extensive damage of primary teeth. This paper evaluates the incidence of SB in children from Itanhandu, MG, Brazil.The presence of teeth wear facets was verified through clinical examinations on a sample of children, whose parents answered a questionnaire about their children's behavior and habits. Analysis of variance and chi-square tests (p = 0.05) were applied to identify possible correlations between the presence of SB and the parents' responses to the questionnaire.The sample comprised of 170 children, 51.76% (n = 88) of which were girls, while the average age was 4.37 (+/- 1.69) years. A total of 15.29% (n = 26) had been diagnosed as bruxers, 46.47% displayed restless behavior, and only 10% used medication. The average duration of breastfeeding was 4.4 (+/- 0.25) months. A positive correlation was found between restless behavior and the presence of SB (p < 0.001). No correlation was found between SB and medication (p = 0.573), or between the duration of breastfeeding and restless behavior (p = 0.102), SB (p = 0.565) and medication (p = 0.794).Restless behavior was positively correlated with SB, although no correlation was found between SB and medication or duration of breastfeeding.