Proposta de avanço para o método Tambor-Pulmão-Corda Simplificado aplicado em ambientes de produção sob encomenda

Recentes aplicações da Teoria das Restrições em Gestão de Operações têm adotado o chamado método Tambor-Pulmão-Corda Simplificado (S-DBR - Simplified Drum-Buffer-Rope) como padrão para planejamento e controle da produção. Contudo, poucas são as referências bibliográficas, especialmente em periódicos nacionais e internacionais, que relatam seus principais conceitos e premissas. Este artigo se propõe a apresentar o método S-DBR para planejamento da produção e sua correspondente abordagem de controle da produção denominado Gerenciamento do Pulmão, aqui abordados em ambientes de produção sob encomenda (MTO - make to order), suas principais características, pressupostos e diferenças em relação ao método DBR clássico. É também apresentada uma proposta complementar ao método S-DBR para estabelecer promessas de entregas urgentes mantendo elevada probabilidade de entrega no prazo.

Avaliação cefalométrica do espaço aéreo posterior em pacientes com oclusão Classe II submetidos à cirurgia ortognática

OBJETIVO: o avanço maxilomandibular é um método cirúrgico comumente usado no tratamento de pacientes acometidos pela Síndrome da Apnéia Obstrutiva do Sono (SAOS) e portadores de anormalidades anatômicas identificáveis neste complexo, que estreitam e/ou obstruem o espaço aéreo. O intuito deste estudo foi analisar variações cefalométricas do espaço aéreo faríngeo em indivíduos Classe II de Angle, após a cirurgia ortognática. METODOLOGIA: a amostra consistiu de telerradiografias laterais equivalentes aos períodos pré e pós-operatório de 30 indivíduos, divididos no grupo com avanço cirúrgico mandibular (n=15) e no grupo com avanço maxilomandibular (n=15). Os parâmetros cefalométricos usados permitiram avaliar o espaço aéreo posterior em 3 níveis: a hipofaringe (PFI-V), a orofaringe (PFM-PM, PFM-PO, PFM-U, PFM-Up) e a nasofaringe (PFM-PN, pm-PFS). A análise esquelética foi na base do crânio (N-S-Ba) e na mandíbula (Ar-Go-Me). A média das diferenças entre os valores pré e pós-operatórios das mensurações lineares (mm) e angulares (graus) foi avaliada pelo teste t pareado. RESULTADOS E CONCLUSÕES: estatisticamente, não houve redução do espaço aéreo faríngeo pós-avanço cirúrgico. O que se observou foi que apenas PFM-PO e PFS-pM se mantiveram constantes e na maioria restante os valores aumentaram.

Electromyographic study of the temporal, masseter and suprahyoid muscles in the mandibular rest position

The temporal muscles (anterior position), and the masseter and suprahyoid muscles were studied electromyographically in 15 subjects with ages ranging from 18 to 35 years, showing normal occlusion (Class I of angle), complete dentition and no dysfunction of the stomatognathic system. The volunteers sat comfortably in a chair, keeping the Frankfurt plane parallel to the boor; the muscles were analysed in the mandibular resting position through a number of stages: with minimum exteroceptive stimuli, relaxation with soft music, abolition of the intrabuccal negative pressure through a plastic tube, stress provoked by an electronic game, disocclusion of posterior teeth using the occlusal splint and finally withdrawal of this device. The electromyographic results were analysed statistically. The samples, were analysed for all of the frequencies of motor units, in a 1-min period. It was found that there were statistically significant difference between the relaxation stages as compared with the withdrawal of negative intraoral pressure and mainly with the stress phase, being this only on the suprahyoid muscles, with 5% significance.

Mandibular skeletal growth and modelling between 10 and 15 years of age

This study pertains to a random sample of untreated French-Canadian adolescents (79 females and 107 males) evaluated at 10 and again at 15 years of age. Superimpositions on natural reference structures were performed to describe condylar growth and modelling of 11 mandibular landmarks. Superimpositions on natural cranial/cranial base reference structures were performed to describe mandibular displacement and true rotation.The results showed significant superior and posterior growth/modelling of the condyle and ramus. Males underwent significantly (P < 0.01) greater condylar growth and ramus modelling than females. With the exception of point B, which showed significant superior drift, modelling changes for the corpus landmarks were small and variable. The mandible rotated forward 2-3.3 degrees and was displaced 9.6-12.7 mm inferiorly and 1.9-2.7 mm anteriorly. Individual differences in ramus growth and modelling, both amount and direction, can be explained by mandibular rotation and displacements. Multivariate assessments revealed that superior condylar growth and ramus modelling were most closely associated with forward rotation and inferior mandibular displacement. Posterior growth and modelling were most closely correlated with anterior mandibular displacement and forward rotation. Modelling of the lower anterior border was independent of rotation and displacement.

Postsurgical stability of oropharyngeal airway changes following counter-clockwise maxillo-mandibular advancement surgery

Purpose: This study evaluated oropharyngeal airway changes and stability following surgical counter-clockwise rotation and advancement of the maxillo-mandibular complex.Methods and Patients: Fifty-six adults (48 females, 8 males), between 15 and 51 years of age, were treated with Le Fort I osteotomies and bilateral mandibular ramus sagittal split osteotomies to advance the maxillo-mandibular complex with a counter-clockwise rotation. The average postsurgical follow-up was 34 months. Each patient's lateral cephalograms were traced, digitized twice, and averaged to estimate Surgical changes (T2-T1) and Postsurgical changes (T3-T2).Results: During surgery, the occlusal plane angle decreased significantly (8.6 +/- 5.8 degrees) and the maxillo-mandibular complex advanced and rotated counter-clock-wise. The maxilla moved forward (2.4 +/- 2.7 mm) at ANS and the mandible was advanced 13.1 +/- 5.1 min at menton, 10 +/- 4.4 mm at point B, and 6.9 +/- 3.7 mm at lower incisor edge. Postsurgical hard tissue changes were not statistically significant. While the upper oropharyngeal airway decreased significantly (4.2 +/- 3.4 min) immediately after surgery, the narrowest retropalatal, lowest retropalatal airway, and the narrowest retroglossal airway measurements increased 2.9 +/- 2.7, 3.7 +/- 3.2, and 4.4 +/- 4.4 mm, respectively. Over the average 34 months Postsurgical period, upper retropalatal airway increased 3.9 +/- 3.7 mm, while narrowest retropalatal, lowest retropalatal airway, and narrowest retroglossal airway remained stable. Head posture showed flexure immediately after Surgery (4.8 +/- 5.9 degrees) and extension postsurgically (1.6 +/- 5.6 degrees).Conclusion: Maxillo-mandibular advancement with counter-clockwise rotation produces immediate increases in middle and lower oropharyngeal airway dimensions, which were constrained by changes in head posture but remain stable over the postsurgical period. The upper oropharyngeal airway space increased only on the longest follow-up. (C) 2006 American Association of Oral and Maxillofacial Surgeons.

ULTRASTRUCTURE OF THE MANDIBULAR GLANDS OF PACHYCONDYLA-STRIATA ANTS (HYMENOPTERA, PONERINAE) .1. WORKERS

The mandibular glands of Pachycondyla striata workers consists of a proximal reservoir and secretory portion. The secretion is transported from the cytoplasm of the secretory cells to reservoir through individual canaliculi which is subdivided into two portions : an intracytoplasmatic and extracellular one. The reservoir consists of an epithelium made up of thin cells has a thick cuticle. The secretory cells showed a large amount of structures forming the citoskeleton always associated with myelin figures.

Comparing the efficacy of mandibular implant-retained overdentures and conventional dentures among elderly edentulous patients: satisfaction and quality of life

Objectives: the aim of this study was to compare the satisfaction and the quality of life in an elderly population using either mandibular conventional dentures or implant-retained overdentures.Materials and methods: A total of 34 patients were divided into two groups: group I-complete dentures users; group II - users of upper complete dentures opposed by implant-retained overdentures. The subjects were submitted to a questionnaire based on Oral Health impact Profile and oral health related quality of life to evaluate their satisfaction levels and quality of life with their prostheses. Data were evaluated using a non-parametric statistical analysis (Fischer test) with significant difference at alpha = 0.05.Results: There were no significant differences between the groups in relation to comfort, aesthetics, chewing ability, overall satisfaction, pain, functional, phonetic, social, and psychological limitations (p > 0.05). Comparing the stability of mandibular dentures, group II presented the better results (p < 0.05).Conclusion: Although the stability of the mandibular implant-retained overdenture was enhanced compared to a conventional denture, the quality of life and satisfaction levels were similar for both the groups.

Influence of the period after ovariectomy on femoral and mandibular bone density and on induced periodontal disease

Background: This study investigated the influence of the period after ovariectomy on femoral and mandibular bone mineral density (BMD) and on induced periodontal disease.Methods: One hundred and twenty-six female Holtzman rats were divided into nine groups: control, sham surgery (SHAM) with and without induction of periodontal disease for 51 and 150 days, and ovariectomy (OVX) with and without induction of periodontal disease for 51 and 150 days. Periodontal disease was induced by placing ligatures on the first lower molars during the last 30 days of each period. BMD was measured by dual-energy x-ray absorptiometry. Vertical bone loss was determined by measuring the distance from the alveolar bone crest to the cemento-enamel junction on the mesial side of the first lower molar.Results: Statistical analyses (Kruskal-Wallis test) revealed a significant difference between the OVX and SHAM groups' global and femoral proximal epiphysis BMD (P < 0.001) for 150 days and in the global evaluation for 51 days. For mandibular BMD, no difference was found between the groups of each period. Influence of the period on femoral BMD was found only for the SHAM groups, with lower BMD for the 51-day period compared to the 150-day period (P < 0.05). In the global evaluation of the mandible, a lower BMD was found after 51 days. The period was a contributing factor for the vertical bone loss, and it resulted in higher values for the 51-day period (P < 0.05).Conclusion: the period influenced the femoral BMD and the vertical bone loss in induced periodontal disease.

Validity and reliability of the Portuguese version of Mandibular Function Impairment Questionnaire

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

Comparative Study of the Mechanical Resistance of 2 Separate Plates and 2 Overlaid Plates Used in the Fixation of the Mandibular Condyle: An In Vitro Study

Purpose: The objective of this study was to carry out a comparative evaluation of the mechanical resistance of 2 rigid internal fixation techniques for fractures of the mandibular condyle using miniplates.Materials and Methods: Fort), polyurethane resin replicas of human hemimandibles were used. The hemimandibles were sectioned to simulate a high subcondylar fracture and then stabilized with 2 fixing techniques using 2.0-mm system plates and screws. The fixation techniques were 2 separate 4-hole plates with 8 screws, and 2 overlaid 4-hole plates with 4 screws. Each system was submitted to load tests, with the application of the load in mediolateral and anteroposterior directions in an Instron 4411 universal assay machine (Instron, Norwood, MA).Results: Load values and peak displacement were measured. Means and standard deviations were evaluated by analysis of variance (P < .05) and Tukey tests, in which it was verified that the anteroposterior peak load value was affected by the arrangement of the plates on the models, although no differences were observed between the groups for the mediolateral peak load. The arrangement of the plates did not have any influence on peak displacement. Similarly, the final value of the mediolateral load was not affected by the arrangement of the plates on the model.Conclusion: The experimental model with 2 separate plates was statistically superior to the model with 2 overlaid plates only in relation to anteroposterior peak load. Despite showing superiority in mediolateral peak load and peak displacement, there was no statistical difference between the groups for these parameters. (C) 2009 American Association of Oral and Maxillofacial Surgeons