Estabilidade sagital da condiloplastia associada à cirurgia ortognática para o tratamento do osteocondroma mandibular

The aim of this study was to evaluate the stability of the conservative condylectomy technique and articular disc repositioning as the surgical treatment approach for management of mandibular condylar osteochondroma, with appropriate Orthognathic surgery. Fifteen patients (12 females and 3 males), average age of 32.3 years (range, 13 to 56 years), with unilateral active osteochondroma of the mandibular condyle were analyzed. All patients underwent conservative condylectomy, recontouring of the remaining condylar neck stump and articular disc repositioned and indicated orthognatic surgical procedures. Average post surgical follow-up was 19 months. Each patient's lateral cephalograms were traced at 3 intervals (presurgery, immediate post surgery and long-term follow-up). Immediate after surgery the oclusal plane angle decreased -2.8 ± 4.5o, the maxillomandibular complex rotated counter-clockwise with advancement at menton 5.3 ± 5.6 mm, pogonion 5.0 ± 5.1 mm, B point 3.4 ± 4.2 mm and A point 1.0 ± 1.5 mm. The long-term follow-up showed significant changes in overbite (-0.6 ± 0.5 mm) and SNGoMe (0,93° ± 1,53°). Horizontally and vertically small instabilities occurred in Me (-1.21 ± 1.94 mm) and PNS (-1.48 ± 1.67 mm) respectively. The treatment protocol studied produced counterclockwise rotation and maxillofacial mandibular advancement. The long-term follow-up showed solid dental and skeletal stability with horizontal instability of Me and PNS in the vertical direction.

Long-term follow-up in sacroiliac joint pain patients treated with radiofrequency ablative therapy

Sacroiliac joint (SIJ) pain is responsible for up to 40% of all cases of lumbar back pain. Objective Report the long-term efficacy of radiofrequency denervation for sacroiliac joint pain at six, twelve and eighteen months. Method Third-two adults’ patients with sacroiliac join pain diagnosis were included for a prospective study. Primary outcome measure was pain intensity on the Numeric Rating Scale (NRS). Secondary outcome measure was Patient Global Impression of Change Scale (PGIC). Results Short-term pain relief was observed, with the mean NRS pain score decreasing from 7.7 ± 1.8 at baseline to 2.8 ± 1.2 at one month and to 3.1 ± 1.9 at six months post-procedure (p < 0.001). Long-term pain relief was sustained at twelve and eighteen months post-procedure, with NRS pain remaining at 3.4 ± 2.1 and 4.0 ± 2.7, respectively. Conclusion Radiofrequency denervation of the SIJ can significantly reduce pain in selected patients with sacroiliac syndrome.

3D superimposition and understanding temporomandibular joint arthritis

Structured AbstractObjectivesTo investigate the 3D morphological variations in 169 temporomandibular ioint (TMJ) condyles, using novel imaging statistical modeling approaches.Setting and sample populationThe Department of Orthodontics and Pediatric Dentistry at the University of Michigan. Cone beam CT scans were acquired from 69 subjects with long-term TMJ osteoarthritis (OA, mean age 39.115.7years), 15 subjects at initial consult diagnosis of OA (mean age 44.914.8years), and seven healthy controls (mean age 4312.4years).Materials and methods3D surface models of the condyles were constructed, and homologous correspondent points on each model were established. The statistical framework included Direction-Projection-Permutation (DiProPerm) for testing statistical significance of the differences between healthy controls and the OA groups determined by clinical and radiographic diagnoses.ResultsCondylar morphology in OA and healthy subjects varied widely with categorization from mild to severe bone degeneration or overgrowth. DiProPerm statistics supported a significant difference between the healthy control group and the initial diagnosis of OA group (t=6.6, empirical p-value=0.006) and between healthy and long-term diagnosis of OA group (t=7.2, empirical p-value=0). Compared with healthy controls, the average condyle in OA subjects was significantly smaller in all dimensions, except its anterior surface, even in subjects with initial diagnosis of OA.ConclusionThis new statistical modeling of condylar morphology allows the development of more targeted classifications of this condition than previously possible.

From quantum to classical instability in relativistic stars

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

A joint experimental and theoretical study on the electronic structure and photoluminescence properties of Al-2(WO4)(3) powders

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Maxillo-mandibular counter-clockwise rotation and mandibular advancement with TMJ Concepts (R) total joint prostheses Part I - Skeletal and dental stability

The purpose of this study was to evaluate skeletal and dental stability in patients who had temporomandibular joint (TMJ) reconstruction and mandibular counterclockwise advancement using TMJ Concepts total join, prostheses (TMJ Concepts Inc. Ventura, CA) with maxillary osteotomies being performed at the same operation. All patients were operated at Baylor University Medical Center, Dallas TX, USA, by one surgeon (Wolford). Forty-seven females were studied; the average post-surgical follow-up was 40.6 months. Lateral cephalograms were analyzed to estimate surgical and post-surgical changes. During surgery, the occlusal plane angle decreased 14.9 +/- 8.0 degrees. The maxilla moved forward and upward. The posterior nasal spine moved downward and forward. The mandible advanced 7.9 +/- 3.5 mm at the lower incisor tips, 12.4 +/- 5.4 mm at Point B, 17.3 +/- 7.0 mm at menton, 18.4 +/- 8.5 mm at pogonion, and 11.0 +/- 5.3 mm at gonion. Vertically, the lower incisors moved upward -2.9 +/- 4.0 mm. At the longest follow-up post surgery, the maxilla showed minor horizontal changes while all mandibular measurements remained stable. TMJ reconstruction and mandibular advancement with TMJ Concepts total joint prosthesis in conjunction with maxillary osteotomies for counter-clockwise rotation of the rnaxillo-mandibular complex was a stable procedure for these patients at the longest follow-up.

Structural alterations of the bladder induced by detrusor instability. experimental study in rabbits

The aim of this study was to evaluate the histopathological and immunohistochemical alterations induced by detrusor instability in the bladder of rabbits submitted to partial bladder outlet obstruction. Thirty male Norfolk rabbits were divided into 2 groups, a clinical control and a group with detrusor instability. Urine culture, cystometric study, histopathological and immunohistochemical analysis were performed in all animals prior to surgery (M1) and 4 weeks after-surgery (M2). Partial obstruction (G2) resulted in a 2.5 fold increment (p < 0.05) in bladder weight when compared to control (G1). Four weeks after surgery, 93% of animals in G2 developed cystitis. Partial obstruction resulted in detrusor instability at M2 and bladder capacity was significantly increased (p < 0.05) from M1 to M2. The incidence of mild to moderate mucosal and adventitious fibrosis at M2 was higher in G2 (p < 0.05) when compared to G1. Inflammatory reaction at M2 was statistically higher (p < 0.05) in G2. There was no difference in muscular hypertrophy between M1 and M2 in G1. However, 67% of G2 bladders showed a moderate to intense muscular hypertrophy at M2. Hyperplasia of the epithelium was also increased in G2 when M1 and M2 were compared (p < 0.05). Detrusor instability induced by partial bladder outlet obstruction caused significant histopathological and immunohistochemical alterations in the bladder of rabbits.

Body posture evaluations in subjects with internal temporomandibular joint derangement

The aim of this study was to verify possible relationships between global body posture and temporomandibular joint internal derangement (TMJ-id), by comparing 30 subjects presenting typical TMJ-id signs to 20 healthy subjects. Body posture was assessed using the analysis of muscle chains on several photographs. Results show a higher frequency of lifted shoulders (p=0.04) and of changes in the antero-internal hip chain (p=0.02) in the test group, but no further differences were found significant between the control and test groups. The test group was then divided into three subgroups according to the Helkimo index of temporomandibular disorder severity. Again, no significant differences were found between the subgroups. However, there was a trend noticed in the group with the most severe dysfunction, to present a forward head and shoulders posture. Results are discussed in light of previous studies using the same sample.

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.

Evaluation of the marsh deer stifle joint by imaging studies and gross anatomy

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

Diagnostic index of three-dimensional osteoarthritic changes in temporomandibular joint condylar morphology

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

Joint economic design of X̄ and R control charts for processes subject to two independent assignable causes

A model for the joint economic design of X̄ and R control charts is developed. This model assumes that the process is subject to two assignable causes. One assignable cause shifts the process mean; the other shifts the process variance. The occurrence of the assignable cause of one kind does not block the occurrence of the assignable cause of another kind. Consequently, a second process parameter can go out-of-control after the first process parameter has gone out-of-control. A numerical study of the cost surface to the model considered has revealed that it is convex, at least in the interest region.

Joint X̄ and R charts with variable parameters

Recent studies have shown that the X̄chart with variable parameters (Vp X̄ chart) detects process shifts faster than the traditional X̄ chart. This article extends these studies for processes that are monitored by both, X̄ and R charts. Basically, the X̄ and R values establish if the control should or should not be relaxed. When the X̄ and R values fall in the central region the control is relaxed because one will wait more to take the next sample and/or the next sample will be smaller than usual. When the X̄ or R values fall in the warning region the control is tightened because one will wait less to take the next sample and the next sample will be larger than usual. The action limits are also made variable. This paper proposes to draw the action limits (for both charts) wider than usual, when the control is relaxed and narrower than usual when the control is tightened. The Vp feature improves the joint X̄ and R control chart performance in terms of the speed with which the process mean and/or variance shifts are detected. © 1998 IIE.

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.