Health professionals ethical and legal liability on patient’s inadequate clarification in order to obtain free and informed consent

It is required that patients are provided information about therapeutic possibilities, showing the risks, benefits, prognosis and costs of each possible and indicated alternative. This is an ethical and legal resolution. However, health professionals possess the clinical/technical/scientific knowledge and determine what information will be (or not) provided. The patient in question decides to undergo a treatment, providing his/her free and informed consent on the basis of the data presented. Unfortunately, some professionals may not provide all the information necessary for making an informed decision or, after obtaining the consent of the patient, may provide him information that causes the patient to give up on the treatment initially accepted. Such information, if relevant, and not a supervening fact, should have been provided initially. However, the information may not be entirely true, and bring the patient, for instance, to decide based on inadequately presented risks. The craniofacial rehabilitation of the temporomandibular joint (TMJ) by means of TMJ prosthesis, is indicated in many situations. Often, patients in need of such prostheses have aesthetic and functional problems and the rehabilitation expectations run high. This work presents a case and discusses ethical and legal issues, including the liability of partial and inadequate information to a patient.

Avaliação tomográfica no tratamento com Herbst em adulto jovem

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Efficiency of occlusal splints on police officers with TMD

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo da assimetria da fossa mandibular, em crânios secos de crianças pelo método radiográfico

The Temporomandibular Joint is a noble structure of the complex mandibular, a lot of research was conducted on the to signs and symptoms of the alterations that attack those structures. ln spite of the high incidence of the DTM in children, there's little knowledge about it, wich makes difficult the treatment Desorders Craniomandibulares (DCM) or Desorders Temporomandibulars (DTM). The Temporomandibular Joint is composed basically by three elements: bones, muscles and disk, in relation to bony part, we have the fossae mandibular that is part of the temporary bone and wich houses the condyle mandibular, accomplishing the articulation among the cranium and the jaw (it leaves piece of furniture of the articulation). Our intention in that work was of verifying a possible asymmetry of the fossae mandibular on the left side and of the right side in relation to two straight line: a straight line that coincided with the plane medium sagittal and another perpendicular straight line to the plan medium sagittal. Analyzing, the fossae mandibular in 91 dry craniums of children, with age varying between four months of life intrauterina and five years, in x-rays in that the incidence was cranium-flow, we could end that: in spite of we find statistical significance in relation to that asymmetry, clinic cannot affirm that interferences on occlusion exists for that asymmetry

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.

Sintomas auditivos e desordens temporomandibulares

Introduction: A variety of hypotheses have been proposed to explain the association between temporomandibular disorders and hearing symptoms, including the many anatomical and/or neurological ways, as of a muscle or joint dysfunction, can cause such symptoms. Objective: The purpose of this study is to discuss, through a systematic review of literature, the interrelation between hearing symptoms and temporomandibular disorders. Material and Methods: We consulted the Medline/PubMed, ISI and Scielo in the period 1918 to 2008. The terms related to the research were: “temporomandibular disorders”, “signs and symptoms of temporomandibular disorders”, “otologic symptoms” and “aural symptoms”, where 19 papers were included using the pre-selected criteria for the manufacture of a meta-analysis. Results: According to the findings, the hearing symptoms most often associated with temporomandibular disorders were otalgia and tinnitus, followed by vertigo and hearing loss, respectively. Conclusions: It’s clear the correlation between hearing symptoms and temporomandibular disorders, however there is a need clinical and scientific research more complex to prove the specific cause-effect relationships between them.

Dor orofacial

The orofacial pain, also known by the generic term dysfunction, is highly prevalent in the general population, causing great discomfort to the patients. For this reason, there is great importance of dentist’s participation in practice and in the process of proper diagnosis of this disease, which in modern times has become increasingly important as guides the best treatment. Thus, this study was aimed to review the main causes, diagnosis, main symptoms and treatment modalities, to serve as a guide to the dentist. Moreover, it also aims to review the main etiologic factors commonly associated, as emotional stress and muscular hyperactivity, to clearly identify signs and symptoms, so the dentist is able to realize simple treatment in your particular office or recognizes complex cases that could be send for treatment to multidisciplinary teams.

Acupuncture as therapeutic resource in patient with bruxism

Bruxism is the harmful habit of clenching or grinding the teeth during the day and / or night, with unconscious pattern, with particular intensity and frequency, outside the functional movements of chewing and swallowing. It is accepted that bruxism is a response controlled by the neurotransmitters dopamine system associated with emotional component. The proposed of treatment of bruxism with acupuncture aims to stimulate sensory fibers of the peripheral nervous system leading to electrical transmission by neurons sufficient to produce changes in the central nervous system. As a consequence there is the release of substances (cortisol, endorphins, dopamine, noradrenaline and serotonin) that promote wellness and restoration of harmony, be it psychological, biological and / or behavioral.

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.

Efeito do filme de carbono DLC aplicado por plasma como recobrimento em Polietileno de Ultra Densidade e Alto Peso Molecular (UHWPE) e planejamento virtual utilizando a técnica de elementos finitos em cirúrgias de próteses totais da ATM

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeito do filme de carbono DLC aplicado por plasma como recobrimento em Polietileno de Ultra Densidade e Alto Peso Molecular (UHWPE) e planejamento virtual utilizando a técnica de elementos finitos em cirúrgias de próteses totais da ATM

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Facial symmetry evaluation after experimentally displaced condylar process fracture in methotrexate treated rats

PURPOSE: To investigate the facial symmetry of high and low dose methotrexate (MTX) treated rats submitted to experimentally displaced mandibular condyle fracture through the recording of cephalometric measurements. METHODS: One hundred male Wistar rats underwent surgery using an experimental model of right condylar fracture. Animals were divided into four groups: A - saline solution (1mL/week); B - dexamethasone (DEX) (0,15mg/Kg); C - MTX low dose (3 mg/Kg/week); D - MTX high dose (30 mg/Kg). Animals were sacrificed at 1, 7, 15, 30 and 90 days postoperatively (n=5). Body weight was recorded. Specimens were submitted to axial radiographic incidence, and cephalometric mensurations were made using a computer system. Linear measurements of skull and mandible, as well as angular measurements of mandibular deviation were taken. Data were subjected to statistical analyses among the groups, periods of sacrifice and between the sides in each group (alpha=0.05). RESULTS: Animals regained body weight over time, except in group D. There was reduction in the mandibular length and also changes in the maxilla as well as progressive deviation in the mandible in relation to the skull basis in group D. CONCLUSION: Treatment with high dose methotrexate had deleterious effect on facial symmetry of rats submitted to experimentally displaced condylar process fracture.