Manifestações orais em crianças em tratamento oncológico

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária

Influence of the lateral pterygoid muscle on the growth of the mandibular condilar cartilage

At the end of the last century, a model to explain clinical observations related to the mandibular growth was developed. According to it, the lateral pterigoid muscle (LPM) was one of the main modulators of the differentiation of mesenquimal cells inside the condyle to condroblasts or osteoblasts, and therefore of the growth of the mandibular condilar cartilage (CCM). The main components of the model were the humoral and the mechanical. Nowadays, the humoral would include growth factors such as IGF-I, FGF-2 and VEGF, which seem to be involved in mandibular growth. Since skeletal muscle can secrete these growth factors, there is a possibility that LPM modulates the growth of CCM by a paracrine or endocrine mechanism. The mechanical component derived from the observations that both the blood flow inside the temporomandibular joint (ATM) and the action of the retrodiscal pad on the growth of the CCM, depend, in part, on the contractile activity of the LPM. Despite the fact that there are some results suggesting  hat LPM is activated under conditions of mandibular protrusion, there is no full agreement on whether this can stimulate the growth of CCM. In this review, the contributions and limitations of the works related to mandibular growth are discussed and a model which integrates the available information to explain the role of the LPM in the growth of the CCM is proposed.

Characteristics of TMD noise analyzed by electrovibratography

Studying joint noise is an important parameter for diagnosing temporomandibular dysfunction. In this study, eight groups (n=9) were formed according to joint dysfunction classification, provided by employing vibration analysis equipment. Parameters for analyzing joint noise were: total vibration energy, peak amplitude, and peak frequency. Mouth opening range was also analyzed. Statistical analysis results for each parameter were significant at 1 %. Each analyzed group presented different noise characteristics. This allowed for inclusion of the groups within a determined value category. The patient group with normal condyle/disk relationship always presented the lowest values. The type of joint noise was characterized by analyzing total integral noise, peak amplitude, peak frequency, and mouth opening. Analyzing joint noise using electrovibratography suggests the type of joint dysfunction and may help to establish a diagnosis, as well as a treatment plan.

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.

Electromyographic analysis of superior belly of the omohyoid muscle and anterior belly of the digastric muscle in mandibular movements

The superior belly of the omohyoid muscle and the anterior belly of the digastric muscle, were studied electromyographically in 20 young volunteers. For each muscle, 1 pair of monopolar electrodes was employed. One was a surface electrode and the other a needle electrode, which was inserted in the belly of the muscle. The surface electrode was placed 1 cm apart from the needle electrode. The most marked action of both muscles was on the movement of lowering the mandible. They also act in those movements for the performance of which they have associated a component of lowering the jaw, propulsion, laterality to the right and the left and retrusion. They are not active in the resting position and during jaw movements of elevation, extrusion and protrusion. Both muscles are active most of the time, simultaneously, but it is not possible to demonstrate that there is a synchronism between their actions.

O forame de Huschke e suas implicações clínicas

During temporal bone development and formation it is noted the presence of a foramen in the medial portion of the external auditory canal (foramen of Huschke). This foramen is normally present until the age of 4 or 5 years old, but in some people it persists throughout life. The persistence of this foramen and its clinical implications related to the temporomandibular joint, ear and nearby structures has been reported by many authors. Therefore, it is important that dentists, otorhinolaryngologists, speech pathologist and physiotherapists have a wide knowledge about the consequences of the presence and persistence of the foramen of Huschke.

Anatomic and radiograph study of the persistence of Foramen of Huschke

Aim: the aim of this study is to assess and locate the Foramen of Huschke. Study design: anatomical. Material and Method: using contrast material like gutta-percha and barium sulfate, through extraoral radiographs, such as panoramic, submental vertex and corrected saggital linear Temporal Mandibular Joint tomograms in four skulls where we clinically checked the existence of foramen of Huschke. Results: The results proved that the foramen of Huschke can be observed in skulls submitted to contrast using radiographic techniques.

Persistência do forame de Huschke: Um estudo tomográfico

OBJECTIVE: To evaluate the persistency of foramen of Huschke by means of computed tomography study of the ear region and approaching important clinical aspects related to the presence of this anatomical anomaly. MATERIALS AND METHODS: Two examiners have analyzed the whole tympanic portion of temporal bone in 150 bilateral computed tomography studies of the ear region, searching for foramen of Huschke presence or absence. RESULTS: The mentioned anatomical anomaly was found in 17 cases (11.3%), 13 patients (76.5%) being female and four (23.5%) male. This higher female incidence is statistically confirmed. CONCLUSION: Ear and/or temporomandibular joint specialists should turn their attention to the persistency of foramen of Huschke.

Insertion of the superior head of the lateral pterigoid muscle in the human fetuses

The lateral pterygoid muscle, more specifically its superior head, as we know, is closely related to the temporomandibular joint (TMJ). Particularly in children, in contrast with what was observed in adults, these joints have been rarely studied, by the anatomic functional aspect, little knowing about its functions in the embryonic and fetal periods. We used, in this work, 12 fetuses ranging in age from 16 to 39 weeks of intrauterine life, where we observed that the superior head of the lateral pterygoid muscle is inserted in the disc and in the articular capsule, in all age groups studied, and also, that the fibers and the thickness of the articular disc is, as well as the articular capsule suffer modifications in accordance with the period of development. © 2007 Sociedad Chilena de Anatom•br>.

Necrotizing sialometaplasia as a cause of a non-ulcerated nodule in the hard palate: A case report

Introduction. Necrotizing sialometaplasia is a benign, self-limiting and rare inflammatory disease which, on clinical and histological examination, mimics malignant neoplasms. Case report. We report the case of a healthy 25-year-old Caucasian woman with a three-week history of a painless lump on her hard palate. Oral examination revealed a nodule consisting of two lobules on the right side that measured 2.5 cm. Her mucosa was normal in color and a fluctuant area was detected in the posterior region upon palpation. Our patient was submitted to incisional biopsy and histopathological examination. The histological diagnosis was necrotizing sialometaplasia. The lesion had healed spontaneously after 30 days, with observed signs of involution of the nodule. Conclusion: Histopathological examination is necessary for the diagnosis of necrotizing sialometaplasia because the clinical features of this condition can mimic other diseases, particularly malignant neoplasms. © 2011 Oliveira Alves et al; licensee BioMed Central Ltd.