Temporomandibular joint ankylosis and salivary mucocele in a cat: case report

Relata-se o caso de um gato de aproximadamente um ano e meio de idade, macho, não castrado, que foi encaminhado por apresentar incapacidade de abrir a boca e aumento de volume flutuante na região intermandibular. As lesões estavam presentes há um ano, desde quando o gato foi encontrado e adotado. A causa não foi determinada. Baseado nos exames físicos e radiográficos diagnosticou-se anquilose da articulação temporomandibular esquerda e mucocele salivar. O aspecto lateral do processo condilar da mandíbula esquerda foi removido, e a mucocele foi tratada por ressecção das glândulas salivares mandibular e sublingual direita e por drenagem da mucocele. Após a cirurgia, o gato mostrou bom uso funcional da mandíbula, sem sinais de desconforto.

Sleep bruxism and temporomandibular disorder: Clinical and polysomnographic evaluation

Objective: To seek better understanding of chronic musculoskeletal facial pain and its relation to sleep bruxism, by comparing patients with sleep bruxism, with and without temporomandibular disorder. Design: Forty sleep bruxism patients were evaluated according to the Research Diagnostic Criteria for Temporomandibular Disorders: group A-20 patients with myofascial pain, 3 men, 17 women; average age 32.7 yr; mean duration of pain 4.37 yr; group B-20 without myofascial pain, 5 men, 15 women; average age 30.8 yr. Sleep and bruxism were evaluated in one-night polysomnography. Results: There were no statistically significant differences for bruxism and sleep variables of the two groups: number of bursts and bruxism episodes per hour, amplitude and duration of bruxism episodes, sleep efficiency and latency, percentage of non-REM and REM sleep, respiratory events, periodic limb movements, and micro-arousals. Conclusions: The polysomnographic characteristics of patients with sleep bruxism, with and without orofacial pain, are similar. More studies are necessary to clarify the reasons why some sleep bruxism patients develop chronic myofascial pain, and others do not. © 2006 Elsevier Ltd. All rights reserved.

The effect of a Lucia jig for 30 minutes on neuromuscular re-programming, in normal subjects

The Lucia jig is a technique that promotes neuromuscular reprogramming of the masticatory system and allows the stabilization of the mandible without the interference of dental contacts, maintaining the mandible position in harmonic condition with the musculature in normal subjects or in patients with temporomandibular dysfunction (TMD). This study aimed to electromyographically analyze the activity (RMS) of the masseter and temporal muscles in normal subjects (control group) during the use of an anterior programming device, the Lucia jig, in place for 0, 5, 10, 20 and 30 minutes to demonstrate its effect on the stomatognathic system. Forty-two healthy dentate individuals (aged 21 to 40 years) with normal occlusion and without parafunctional habits or ternporomandibular dysfunction (RDC/TMD) were evaluated on the basis of the electromyographic activity of the masseter and temporal muscles before placement of a neuromuscular re-programming device, the Lucia jig, on the upper central incisors. There were no statistically significant differences (p < 0.05) in the electromyographic activity of the masticatory muscles in the different time periods. The Lucia jig changed the electromyographic activity by promoting a neuromuscular reprogramming. In most of the time periods, it decreased the activation of the masticatory muscles, showing that this device has wide applicability in dentistry. The use of a Lucia jig over 0, 5, 10, 15, 20 and 30 minutes did not promote any statistically significant increase in muscle activity despite differences in the data, thus showing that this intra-oral device can be used in dentistry.

Optimal mean-variance control for discrete-time linear systems with Markovian jumps and multiplicative noises

In this paper, we consider the stochastic optimal control problem of discrete-time linear systems subject to Markov jumps and multiplicative noises under two criteria. The first one is an unconstrained mean-variance trade-off performance criterion along the time, and the second one is a minimum variance criterion along the time with constraints on the expected output. We present explicit conditions for the existence of an optimal control strategy for the problems, generalizing previous results in the literature. We conclude the paper by presenting a numerical example of a multi-period portfolio selection problem with regime switching in which it is desired to minimize the sum of the variances of the portfolio along the time under the restriction of keeping the expected value of the portfolio greater than some minimum values specified by the investor. (C) 2011 Elsevier Ltd. All rights reserved.

Developmental Brain Dysfunction: Revival and Expansion of Old Concepts Based on New Genetic Evidence

Neurodevelopmental disorders can be caused by many different genetic abnormalities that are individually rare but collectively common. Specific genetic causes, including certain copy number variants and single-gene mutations, are shared among disorders that are thought to be clinically distinct. This evidence of variability in the clinical manifestations of individual genetic variants and sharing of genetic causes among clinically distinct brain disorders is consistent with the concept of developmental brain dysfunction, a term we use to describe the abnormal brain function underlying a group of neurodevelopmental and neuropsychiatric disorders and to encompass a subset of various clinical diagnoses. Although many pathogenic genetic variants are currently thought to be variably penetrant, we hypothesise that when disorders encompassed by developmental brain dysfunction are considered as a group, the penetrance will approach 100%. The penetrance is also predicted to approach 100% when the phenotype being considered is a specific trait, such as intelligence or autistic-like social impairment, and the trait could be assessed using a continuous, quantitative measure to compare probands with non-carrier family members rather than a qualitative, dichotomous trait and comparing probands with the healthy population. Copyright 2013 Elsevier Ltd. All rights reserved.

Nitric oxide metabolite production in the cranial cruciate ligament, synovial membrane, and articular cartilage of dogs with cranial cruciate ligament rupture

OBJECTIVE To measure concentrations of nitric oxide metabolites (nitrite-nitrate [NOt]) in cartilage, synovial membrane, and cranial cruciate ligament (CCL) in dogs and evaluate associations with osteoarthritis in dogs with CCL rupture. ANIMALS 46 dogs with CCL rupture and 54 control dogs without joint disease. PROCEDURE Tissue specimens for histologic examination and explant culture were harvested during surgery in the CCL group or immediately after euthanasia in the control group; NOt concentrations were measured in supernatant of explant cultures and compared among dogs with various degrees of osteoarthritis and between dogs with and without CCL rupture. RESULTS Osteoarthritic cartilage had significantly higher NOt concentration (1,171.6 nmol/g) than did healthy cartilage (491.0 nmol/g); NOt concentration was associated with severity of macroscopic and microscopic lesions. Synovial membrane NOt concentration did not differ between dogs with and without CCL rupture. Ruptured CCL produced less NOt than did intact ligaments. In control dogs, NOt concentrations were similar for intact ligaments (568.1 nmol/g) and articular cartilage (491.0 nmol/g). Synthesis of NOt was inhibited substantially by coincubation with inhibitors. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that NOt in canine joint tissues originates from the inducible nitric oxide synthase pathway. Nitric oxide metabolite production in cartilage was greater in dogs with osteoarthritis than in healthy dogs and was associated with lesion severity, suggesting that nitric oxide inhibitors may be considered as a treatment for osteoarthritis. The CCL produces substantial concentrations of NOt; the importance of this finding is unknown.

Prevalência de sinais e sintomas de Disfunções Temporomandibulares em pacientes que se dirigem à consulta de Otorrinolaringologia

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

O efeito da espessura da placa interoclusal sobre a atividade elétrica e a temperatura dos músculos temporal anterior e masseter durante o repouso e o apertamento dental

Pós-graduação em Odontologia - FOA

Relationship between psychological factors and symptoms of TMD in university undergraduate students.

Temporomandibular disorders is a collective term used to describe a number of related disorders involving the temporomandibular joints, masticatory muscles and occlusion with common symptoms such as pain, restricted movement, muscle tenderness and intermittent joint sounds. The multifactorial TMD etiology is related to emotional tension, occlusal interferences, tooth loss, postural deviation, masticatory muscular dysfunction, internal and external changes in TMJ structure and the various associations of these factors. The aim of this study was to evaluate the prevalence of the relationship between signs of psychological distress and temporomandibular disorder in university students. A total 150 volunteers participated in this study. They attended different courses in the field of human science at one public university and four private universities. TMD was assessed by the Research Diagnostic Criteria (RDC) questionnaire. Anxiety was measured by means of a self-evaluative questionnaire, Spielberger's Trait-State anxiety inventory, to evaluate students'state and trait anxiety. The results of the two questionnaires were compared to determine the relationship between anxiety levels and severity degrees of chronic TMD pain by means of the chi-square test. The significance level was set at 5%. The statistical analysis showed that the TMD degree has a positive association with state-anxiety (p = 0.008; p < 0.05) and negative with trait-anxiety (p = 0.619; p < 0.05). Moreover a high TMD rate was observed among the students (40%). This study concluded that there is a positive association between TMD and anxiety.

Stress levels and quality of sleep in subjects with temporomandibular joint dysfunction

Purpose: The aim of this study was to test the association between quality of sleep and stress in individuals with temporomandibular disorder (TMD). Methods: The study sample consisted of 354 adult subjects (males and females) from the municipality of Piacatu, São Paulo state, in the Southeast region of Brazil. Data were collected using the Fonseca’s Questionnaire to record the level of TMD, the Pittsburgh Sleep Quality Index (PSQI) to assess quality of sleep and the Social Readjustment Rating Scale (SRRS) to record stress level. The data were analyzed by the software Epi Info 2000 version 3.2 using a chi-square test at the 0.05 level of significance. Results: One hundred and eighty (50.8%) subjects had some level of TMD. The statistical analysis showed a significant relationship between the three stress scores and the presence or absence of sleep disorders, considering an overall PSQI score > 5 as an indicator of a subject with sleep problems (P<0.01). Conclusion: Both quality of sleep and stress levels were associated with TMD in this sample.

Relationship between internal derangement of temporomandibular joint and changes in body posture

Background: The presence of body posture changes among patients with temporomandibular disorders (TMD) has been a controversial issue in the literature, in which it supporters point out the muscular origin as the main etiological factors, mainly associated with postural changes in head. Due to this controversy, it is pertinent to check whether this relationship exists on the most common etiology of TMD, the disk displacement, which translates a biomechanical internal disorder of the temporomandibular joint (TMJ). Objectives: Assess body posture changes in subjects with internal derangement of the TMJ when compared to subjects without this biomechanical dysfunction, characterize the patterns of the jaw movements and assess to the muscle activation during jaw movements. Methods: 21 subjects with TMJ disc displacement (DD) (test group) and 21 subjects without any TMD (control group) was assessed for body posture changes through evaluation of several body segments by posturography and also was evaluated the postural balance reactions through the center of mass during jaw movements using a balance platform. For the characterization of the jaw movement patterns it was done a kinematic analysis during jaw movements (active ROM and path of the jaw). For the muscle activation during jaw movements it was evaluated the masseter, sternocleidomastoid and spinae erector muscles by surface electromyography (EMG). Results Discussion: Both groups show forward head posture and extension of the cervical spine, not noticing any other significant body posture changes in subjects with DD, and if we had to see in detail, in general, subjects without TMD shows more body posture changes than subjects with DD. The pattern of jaw movements is similar in both groups, but in subjects with DD the closing movements are more instable than the opening movements, related to a less effective movement control to counteract the force of gravity and the disk displacement. The bilateral muscle activation during jaw movements is higher in subjects with DD, likely related to a less stable pattern of movement which leads in a higher muscle activation to guide the movement and ensure the best as possible articular stability. Conclusion: The disk displacement with reduction should be viewed as part of a set of signs and symptoms that require an accurate musculoskeletal and psychosocial assessment towards an earlier diagnosis for reduction and control of the functional limiting factors. In this direction, it seems that the relevant set of limiting signs and symptoms deserve a particular attention by health care practitioners involved in the assessment and treatment of TMD, in order to define effective therapeutic options.

Qualidade de Vida, Saúde Geral e Ansiedade em pacientes com diferentes tipos e níveis de disfunção temporomandibular

Some studies reported in the literature that emotional factors and quality of life may be involved both in aetiology, as in the progression of Temporomandibular disorders (TMD). Proposition: The purpose of this study is to observe a possible association between different forms of anxiety, quality of life and general health of patients diagnosed as carriers of various types and levels of Temporomandibular Dysfunction. Methodology: The sample consisted of 60 patients diagnosed as carriers of TMJD origin of muscle, joint, or both, with different levels of severity (mild TMD, moderate and severe). The patients were diagnosed with TMD-RDC (Research Diagnostic Criteria) to assess the type of dysfunction (muscle or joint) and by the Protocol of Fonseca to verify the degree of dysfunction (mild, moderate or severe). To evaluate the psychosocial aspects were used three self-applied, with the purpose of obtaining information about the general health (General Health Questionnaire - GHQ), the type of anxiety (Trait Anxiety Inventory-State - STAI) and quality of life (World Health Organization Quality Of Life Short WHOQOL-brief). Results: There was a correlation between all indicators studied in several forms of TMD with varying degrees of commitment. Quality of life appeared linked to the type and the level of TMD: Muscular and Articular TMD (p = 0,037), Disk Displacement With Reduction (p = 0.01) and Mild TMD (p = 0.042). The General Health showed association with the level of TMD, with the exception of the stress factor (p = 0.78). For the analysis of the types and levels to Severe Muscular TMD had a statistically significant indicator of the quality of life (p = 0049). The anxiety only showed association with the level of TMD (p = 0,047 for anxiety-trait). Conclusion: Besides the limitations of the study, it was concluded that anxiety, quality of life and general health are important psychosocial indicators, which are linked to several forms of TMD in different levels of severity

Disfunção temporomandibular: relação com a classe sócio-econômica, qualidade do sono e estresse

Pós-graduação em Odontologia Preventiva e Social - FOA