Acupuntura em disfunção temporomandibular: relato de caso clínico

A técnica milenar da Acupuntura vem sendo empregada na Odontologia e obtendo bons resultados em diversas situações. Analgesia, relaxamento muscular e inflamação vêm sendo controlados, demonstrando assim conexão entre Acupuntura e redução de certas sintomatologias. As reações locais e à distância necessitam de correto posicionamento das agulhas assim como integridade do sistema nervoso, e são decorrentes da liberação de neurotransmissores (noradrenalina, acetilcolina, serotoninas e dopamina). Dentro da Odontologia, podemos nos utilizar dos seus efeitos no pré e pós operatório, em xerostomia, cefaléias, trismos, disfunção de ATM por estresse, parestesias, paresias, ansiedade, entre outras condições. Nos casos de disfunção de Articulação Temporomandibular por hiperatividade muscular, podemos utilizar a Acupuntura ao invés de relaxante muscular e antiinflamatório. Nesse trabalho, apresentaremos um caso clínico (paciente MCH, 23 anos, gênero feminino), a qual apresentava crises de dor de cabeça (região temporal), fazendo uso constante de medicação analgésica e antiinflamatória, o diagnóstico estabelecido foi Dor Muscular Local associado à hiperatividade muscular. Através do uso da Acupuntura, após aplicações semanais por 3 meses, houve remissão da dor por completo.

Fatores biomecânicos relevantes na seleção dos grampos em próteses parciais removíveis com extremo livre: estudo clínico

The free-end removable partial dentures (RPD) shows a complicated and peculiar biomechanical behavior that impose high occlusion forces to the abutment teeth. By this way, the aim of this study was to evaluate the several factors that influence the clasps indication to free-end RPD. It was analysed 84 designed and planned study models of 71 patients, involving 130 clasps near-by a free-end; followed by clinical and radiographical informations. It was observed that bar clasps (“T”, “Tmod”, “i”) were used in 88.46% of abutment teeth. In the others (11.55%), it was used simple, combinated or ring circumferential clasps, and MDL. In abutment teeth with high equator line the “i” clasps were predominant (48.48%). The “Tmod” clasps were predominant in abutment teeth with low equator line (50%) or in middle third (51.35%) and “T” clasps were predominant in inclined equators with mesio-buccal (56.52%) or disto-buccal (66.66%) retention. In the posterior abutment teeth, it was prevalent the distal rest (63.52%) and embracing to the adjacent tooth. Some others factors like long clinical crown (5.38%), wrong position of abutment teeth (4.61%), aesthetics (3.07%), retention in alveolar ridge (2.3%), fragility of abutment teeth (1.53%), short clinical crown (0.76%) and short space to the clasp (0.76%) influenced directly during the clasps selection. Factors like mobility of abutment teeth, height of muscular insertions, depth of buccal fornix and antagonist arch acted like secondary factors. After the informations analysis it may be concluded that the bar clasps with distal rest and embracing to the adjacent tooth were the most indicated to free-end RPD

Prótese total imediata: relato de caso clínico

The immediate complete denture is defined as a removable or partial denture made to be installed immediately after the extraction of the natural teeth. This type of prosthesis can be used for a short period of time, for aesthetic reasons, mastication, occlusal support, convenience or for the adaptation of the patients to the edentulous state, until the final prosthesis is installed. The objective of this study was to report a surgical and prosthetic rehabilitation planning of a patient by means of an immediate complete maxillary denture, and the results obtained with this treatment modality. The immediate complete denture is a necessary, well-established, useful and effective prosthetic procedure for patients who, inevitably, will present an edentulous state, despite it is a slightly more expensive and it requires more sessions for adjust

Planejamento reverso em implantodontia: relato de caso clínico

The oral rehabilitation has achieved great prominence in the dental implant, especially in the cases of reposition of units dental elements, so it is possible to replace each missing element to implant into your space where the tooth was loss. The reverse planning is fundamental to an appropriate rehabilitation, because promote the elimination of problems that might compromise the aesthetics and function of future dental implants. The objective of this study was to report the treatment plan for a patient in need of oral rehabilitation with implant dental prosthesis, using indications and techniques based on the literature, emphasizing the importance of reverse planning. We conducted an osseointegrated implant surgery using the principles of a connect procedure, thus allowing their successfully installing increasing the predictability of treatment. It is concluded that the success of rehabilitation treatment is directly related to the initial planning, a correct clinical approach and an integrated multidisciplinary team.

Protocolo para tratamento de diastemas com laminados de porcelana: descrição de caso clínico

A percepção e o alcance da excelência estética traduzem-se especialmente em saber interpretar e satisfazer os anseios dos pacientes, empregando-se para isso todo o conhecimento disponível na literatura científica. No tratamento com laminados cerâmicos, a ciência fornece parâmetros para nos guiar com relação a um correto diagnóstico, planejamento seguro, técnica adequada e material mais indicado; porém, a subjetividade estética pode estar escondida nas entrelinhas da ciência. Contudo, o objetivo deste artigo é descrever um protocolo para fechamento de múltiplos diastemas, salientando a técnica empregada, bem como o material cerâmico utilizado e suas peculiaridades, implícitas dentro de um contexto estético específico.

Sinais e sintomas na Síndrome de Costen associada a desordens temporomandibulares: relato de caso clínico

Costen’s syndrome is defined as a set of auditory signs and symptoms in patients with TMD. It is characterized by ear fullness, hearing loss, tinnitus, ear pain and vertigo with nystagmus.It has predilection for females and fourth decade of life. The multidisciplinary monitoring of these patients is imperative in its recognition and the establishment of effective therapy. In this paper we report a case of Costen’s Syndrome patient whose treatment consisted of advice on the etiology of the disorder and weekly sessions of acupuncture. The clinical features that led to the diagnosis and treatment plan, and the effectiveness of acupuncture as supportive therapy were also discussed.

La relacion entre la calidad de la ensenanza y mala prática odontológica: relato de un caso clínico

The activities developed in health area are of great importance, because they have the aim to preserve the life of the men, and therefore, must be performed by authorized persons. The increase of the number of dental schools, the decline at the education quality and a higher admission of students with low ability to exercise their profession, are facts that bring disastrous consequences for society. These facts are, also, reflected at the moral, ethical and technical-scientific performance of the professional. The purpose of this clinic case is to show that although there is a significant suplly of education institutions, there is a lack of scientific and adequate technical knowledgement from the graduated dentals surgeons. The patient MSL, 17 year old, female, went to a dental clinic presenting a tray type Vernis, attached to the lower arch. After clinical evaluation, it was showed that an incorrect material was used for the impression technique, being impossible to take out the tray by the conventional manner. The planning for the removal of the tray was through the divide of it. Thus, the consequence of the lack of knowledge in the use of impression materials had caused a great incovinience to the patient. It can be concluded that the rate of malpractice is directly related to the professional preparation, highlighting the importance of quality dental education for a responsible clinical practice.

Parâmetros assistenciais em saúde bucal: comparação entre duas programações do atendimento clínico no serviço público

Objective: To compare two forms of scheduling clinical dental care for the oral health teams (OHT) included in the strategy of family health, regarding productive aspects of assistance. Methods: Two OHT worked concurrently, using two methods of clinical care: the parameter recommended by the Ministry of Health Ordinance No. 1101, 2002, which establishes 03 dental visits per hour (c/h) per team, and a Testing model, with 02 c/h, being each method applied for a period of 615 hours. The quantitative data was collected in OHTs’ daily production spreadsheets, covering the following items: the number of dental visits (initial, for maintenance and for emergency procedures), procedures performed, consumption of material and sterilization cycles. Data was compared and statistically analyzed through the BioStat 5.0 by applying the paired t-test (p <0.05). Results: Under the Ministerial method and the Testing model, were performed, respectively, 288 and 365 first dental visits, 921 and 686 return dental visits, 167 and 172 emergency dental attendances, with 469 and 110 fouls, 212 and 327 treatments were finished and 2501 and 3046 dental procedures were realized. Among eleven analyzed consumables, five were consumed in smaller quantities in the Testing model: gloves (9%), anesthesia (38%), anesthetic needle (34%), suture material (24%) and aspirators (11%), while the six remaining items presented similar consumption rates between the two models. Conclusions: The testing model revealed to be more productive and economical.

A relevância do periodontista na prevenção da doença periodontal em pacientes ortodônticos: relato de caso clínico

The increase of the retentive areas of bacterial plaque can be observed in patients who use dental braces in the mouth. The difficulty of making hygienic is one of the problems that this particular group of patients faces day by day, and consequently, the establishment of gingival inflammation becomes more frequent. The objective of this case report is to show the importance of the periodontist in preventing and promoting health to the users of dental braces, aimed at education and motivation as one of the priorities of this treatment. The ESA patient, 29 years old, male, attended the dental office of a periodontist, sent by the orthodontist, due to the extensive area of gingival hyperplasia and gingivitis, in both arches. The possibility of taking out the dental braces was considered by the orthodontist, but after the periodontist evaluation, this step was procrastinated. Thus, the periodontist started the adequacy of the oral environment together with the work of education and promotion of health, which lasted until the complete recovery of the healthy gingival condition of the patient. In this way, it is possible to observe the relevance of the work of the periodontist in the application of preventive methods in oral health for orthodontic patients. The motivation of these patients in relation to the orientations of buccal hygienic, maintenance of oral health and diet should not be considered as secondary and should be prioritized, because only in this way it would be possible to reach a good occlusion, without esthetic and functional prejudice.

Odontoma em pacientes odontopediátrico: diagnóstico e tratamento. Relato de caso clínico.

Odontoma is a term that refers to a benign tumor of odontogenic and mixed nature, composed of epithelial and mesenchymal components. Histologically, they are compounds of different configurations including dental enamel, dentin, cementum and in some cases the pulp tissue. A slow growing asymptomatic tumor, odontoma is usually discovered through routine radiographic examination. A 3-year old male patient sought care at the School of Dentistry’s Baby Clinic (UNESP-Araçatuba), complaining of “small ball close to the teeth.” During the interview, the mother reported that the lesion was observed soon after a trauma, and evolved in less than one month. An ulcerated lesion with a 0.8 cm diameter was found during intraoral clinical examination. It was located in the inferior and anterior region of the mouth, between teeth 81 and 82, and there was also crown distalization. A radiographic examination showed a radiolucent area and root distance. In the absence of clinical and radiographic characteristics suggesting a case of odontoma, the differential diagnosis was peripheral giant cell lesion and pyogenic granuloma. So the area was punctured. Nonetheless, due to the absence of liquid, the surgical removal of the lesion was performed, followed by histological examination, which showed the definite diagnosis of a suggestive case of emerging odontoma.

Mordida cruzada posterior, correccion y consideraciones: caso clínico con 7 años de seguimiento

Early treatment of functional unilateral posterior crossbite during the mixed dentition is extremely important for contemporary Orthodontics, provides the correct positioning of osseous bases, teeth and temporomadibular joint when the stomatognathic system is in growth and development. These results generally develop into an adequate craniofacial relationship, reducing the necessity for more complex treatments at permanent dentition. The subject of this paper was to report patient 8 years old, diagnosed with functional unilateral posterior crossbite, and was treated by an expander appliance type Quad-helix emphasizing the long-term stability. The malocclusion was corrected in 3 months of active use of the appliance, 3 months for retention purposes and followed up during 7 years post-treatment. The stability in long term of functional unilateral posterior crossbite treated is closely related with early diagnostic, the elimination of the etiological factor associated with a correct appliance and the mechanic of treatment.

Odontoma composto: relato de caso clínico

Os odontomas são os tipos mais comuns de tumores odontogênicos, sendo sua constituição principalmente de esmalte e dentina, com quantidade variável de cemento e polpa. Apresenta relação com dentes inclusos e sua etiopatogenia é desconhecida. Radiograficamente pode ser classificado como composto ou complexo. Acomete com mais frequência pacientes entre a primeira e segunda década de vida, e não há predileção por sexo. Localiza-se principalmente em região anterior de maxila, assintomático e tem associação com dentes inclusos e supranumerários. Neste trabalho relatamos um caso clínico, cuja paciente foi encaminhada para avaliação devido a ausência do dente 33. O diagnóstico clinico-radiográfico inicial foi de odontoma composto. Realizou-se a remoção cirúrgica da lesão e do dente incluso tendo o exame histopatológico confirmado o diagnóstico de odontoma composto.

Achados incidentais de calcificações em tecidos moles: relato de caso clínico

As ossificações do complexo estilo-hióideo (OCEH), os tonsilólitos e os ateromas são exemplos calcificações em tecidos moles incidentalmente encontrados em exames de imagem. Atualmente com a utilização da tomografia computadorizada de feixe cônico (TCFC) na odontologia, há um aumento do número desses achados. Objetivo: Relatar um caso clínico com calcificações em tecidos moles e comparar esses achados entre a radiografia panorâmica e a TCFC do mesmo paciente. Paciente masculino, 77 anos, compareceu a Clínica de Radiologia para realizar radiografia panorâmica e TCFC para planejamento de implantes. Na radiografia panorâmica pode-se observar a OCEH bilateral e presença de uma área radiopaca localizada no ramo ascendente da mandíbula, que foi compatível com esclerose óssea. Na análise da TCFC constatou a presença da OCEH bilateralmente. Porém a área radiopaca primeiramente sugestiva de esclerose óssea, na TCFC foi sugerida como tonsilólito, pois não estava localizada no ramo ascendente da mandíbula, e sim nos tecidos moles da região próxima aos espaços aéreos. No exame de TCFC foi possível a visualização de outra estrutura calcificada do lado direito do paciente, na altura da vértebra C4, heterogênea que foi compatível com ateroma. O diagnóstico das calcificações pode não ser preciso quando se utiliza apenas a radiografia panorâmica, além da possibilidade de apresentar falso negativo, como no caso do ateroma. Assim sendo quando o paciente possuir o exame de TCFC esse deve ser completamente avaliado, para que sejam diagnosticadas as possíveis calcificações em tecidos moles presentes.

Infecções odontogenicas: relato de caso clínico e implicações terapêuticas

Acute infections maxillo-facial are of great importance, both for its high population, as the risk of complications. The aim of this study was to present a clinical case of extensive odontogenic abscess in a patient of 31 years of age attended the Service of Surgery and Maxillo-Facial, Faculty of Dentistry of Araçatuba - UNESP in Araçatuba, SP. Complications of infections odontogências although infrequent can lead the patient to death.

Reabilitação protética de mandíbula atrófica por meio de implantes curtos: relato de caso clínico com oito anos de acompanhamento

This case report shows how the prognosis of severe mandibular atrophy can be improved with the use of short dental implants. A Caucasian 54 years-old male patient received four dental implants in the anterior mandibular region. Four months later, the definitive prosthesis was delivered. At the 8-year follow-up period, no complaints or loss of integration were reported. Short dental implants with complete, fixed definitive prosthesis can be a successful treatment in the mandibular arch.