[Show abstract][Hide abstract] ABSTRACT: Loss of posterior teeth may cause an imbalance in the stomatognathic system. Overlay removable partial dentures (ORPD) are a reversible and relatively inexpensive treatment for patients with severely worn teeth. This paper presents a treatment with ORPD in a 55-year-old male patient who had severe attrition in the maxillary and mandibular teeth, temporomandibular joint pain and reduced vertical dimension of occlusion (VDO). The treatment consisted in the reestablishment of the VDO using Lucia's jig, fabricating removable partial denture with reconstruction of the worn teeth without preparation. This therapy can be used as an alternative treatment to provide esthetic, function and stable occlusion in patients with severely worn teeth.
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to analyze the effect of low level laser applied to acupuncture points of patients diagnosed with temporomandibular dysfunction (TMD). Ten patients aged between 20 and 50 years were clinically examined with regard to pain and dysfunction of the masticatory system. They received laser applications (GaAlAs diode laser, 780 nm wavelength; 70 mW power output, 35 j/cm(2)) in acupuncture specific points (Ig4, C3, E6, E7) once a week, for ten sessions. The range of jaw movement was registered after each session and visual analogue scale (VAS) was applied. Results were analyzed (SPSS-15.0-Chicago) during the comparison, before and after treatment. Statistical tests showed significant improvements (p < 0.01) in painful symptoms and electromyographic activities of masseter muscles in maximal habitual occlusion after laser applications but no significant improvements (p = 0.05) in measurements of mandibular movements. The laser therapy in specific acupuncture points promoted improvement of symptoms and it may be used as complementary therapy for TMD.
Complementary therapies in clinical practice 08/2010; 16(3):158-60.
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to evaluate the effectiveness of low-level laser therapy (LLLT) on the improvement of the mandibular movements and painful symptoms in individuals with temporomandibular disorders (TMD). Forty patients were randomly divided into two groups (n=20): Group 1 received the effective dose (GaAlAs laser λ 830 nm, 40 mW, 5J/cm²) and Group 2 received the placebo application (0 J/cm²), in continuous mode on the affected condyle lateral pole: superior, anterior, posterior, and posterior-inferior, twice a week during 4 weeks. Four evaluations were performed: E1 (before laser application), E2 (right after the last application), E3 (one week after the last application) and E4 (30 days after the last application). The Kruskal-Wallis test showed significant more improvements (p<0.01) in painful symptoms in the treated group than in the placebo group. A significant improvement in the range of mandibular movements was observed when the results were compared between the groups at E4. Laser application can be a supportive therapy in the treatment of TMD, since it resulted in the immediate decrease of painful symptoms and increased range of mandibular movements in the treated group. The same results were not observed in the placebo group.
[Show abstract][Hide abstract] ABSTRACT: Objectives: this work was performed with the purpose of investigating the electromyographic activity (EMG) of the anterior temporalis and masseter muscles in edentulous individuals with temporomandibular disorder (TMD), before and after using sliding plates on complete dentures in mastication and maximal clenching. The patients were edentulous at last ten years. Methods: the EMG recordings were made before the insertion of the dentures (0 month) and also after using the sliding plates at the 4th month, 9th month, and 12th month, using a computerized electromyography.The electromyographic (EMG) evaluations of the muscles were perfomed under the following clinical conditions: habitual mastication with hyperboloid (M1), rigth molar mastication with hyperboloid (M2), left molar mastication with hyperboloid (M3), maximal clenching with dentures (C1), maximal clenching without dentures (C2). Results: the results were submitted to variance analysis (mastication) and student t test (maximal clenching). Conclusions: In mastication - the EMG of massater muscle was significantly higher than temporalis (p<0,01); in M2 the EMG of the rigth side was significantly higher than the left side (p<0,01); in M3 the EMG of the left side was significantly higher than the right side (p<0,01); there were no significant differences between periods of evaluation. In maximal clenching - in C1 there were no significant differences between muscles, sides, and periods of evaluation; in C2, the EMG of the muscles increased significantly after using the sliding plates (p<0,05); the EMG of the temporalis muscle was significantly higher than masseter(p<0,01); there were no significant differences between sides
[Show abstract][Hide abstract] ABSTRACT: Temporomandibular joint (TMJ) sounds are important and common physical signs of temporomandibular disorders (TMD). The aim of this study was to evaluate the influence of the effect of the use of occlusal bite splints (stabilizing and repositioning) on the sounds produced in the TMJ, by means of the electrovibratography (EVG). Thirty-one patients with TMD from the Dental School of Ribeirão Preto, University of São Paulo, Brazil were selected for this study. Group 1 (n=23) wore stabilizing bite splints and Group 2 (n=8) used anterior repositioning splints. Before and after treatment with occlusal splints both groups were analyzed using the SonoPAK Q/S recording system (BioResearch System, Inc.). The treatments with stabilizing bite splints were satisfactory, since they reduced the total amount of the sound energies (p<0.05), but the use of anterior repositioning splints for no more than 4 weeks produced significantly better results (p<0.01). The total amount of vibration energy involved in the vibrating movements of the TMJ showed significant improvement using anterior repositioning splints.
[Show abstract][Hide abstract] ABSTRACT: Studying joint noise is an important parameter for diagnosing temporomandibular dysfunction. In this study, eight groups (n=9) were formed according to joint dysfunction classification, provided by employing vibration analysis equipment. Parameters for analyzing joint noise were: total vibration energy, peak amplitude, and peak frequency. Mouth opening range was also analyzed. Statistical analysis results for each parameter were significant at 1%. Each analyzed group presented different noise characteristics. This allowed for inclusion of the groups within a determined value category. The patient group with normal condyle/disk relationship always presented the lowest values. The type of joint noise was characterized by analyzing total integral noise, peak amplitude, peak frequency, and mouth opening. Analyzing joint noise using electrovibratography suggests the type of joint dysfunction and may help to establish a diagnosis, as well as a treatment plan.
Cranio: the journal of craniomandibular practice 08/2008; 26(3):222-8. · 1.11 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The signs and symptoms of temporomandibular dysfunction (TMD) may contribute to reduce bite force and muscular activity. The aims of this study were to compare bite force in complete denture wearers with TMD (TMD group) and without TMD (healthy group).The TMD group consisted of 9 individuals, who had worn a maxillary and a mandibular complete removable denture for more than 10 years. The healthy group consisted of 9 participants who wore dentures and had satisfactory interocclusal and maxillomandibular relationship. Helkimo Index was used to analyze the dysfunction level. Maximum bite force was measured using a digital dynamometer with capacity of 100 kgf and adapted to oral conditions.The TMD group presented smaller mean bite force values than the healthy group, though without statistical significance (p>0.05). This outcome suggests that the TMD signs and symptoms and the structural conditions of the dentures did not affect the maximal bite force of complete denture wearers.
[Show abstract][Hide abstract] ABSTRACT: This paper reports the case of a patient who presented limited buccal opening, though, without apparent symptomatology. The patient was partially toothless and exodontia of the remaining teeth was indicated. Clinical examination and clinical interview were performed as well as panoramic radiograph, transcranial radiograph of the temporomandibular joints (TMJ) and, later, computed tomography (CT), emphasizing the importance of complementary exams in the diagnostic phase. Analysis of the CT scan confirmed the structural alteration in the condylar and coronoid processes of the jaw, explaining the limited buccal opening. The remaining teeth were extracted and complete upper and lower dentures were fabricated, reestablishing the occlusal relationship and the patient's stomatognathic functions. Surgical treatment of the coronoid process was discarded.
[Show abstract][Hide abstract] ABSTRACT: The objective of the present study was to test a protocol for the quantification of the frequency and severity of signs and symptoms of temporomandibular disorders (TMD) according to patient perception during two phases of investigation. The protocol was developed based on the signs and symptoms most frequently reported in the literature and on the circumstances in which they produce discomfort. Eighty-four patients diagnosed with TMD by functional examination of the masticatory system responded to the protocol questions and indicated the severity of signs and symptoms using an eleven point numerical scale (Phase 1). Forty-two patients were fitted with an occlusal splint (treated group) and the remaining participants did not use a splint (control group). The protocol questions were asked after 50 days of treatment (Phase 2). Based on the results of nonparametric statistical analysis, the incidence of signs and symptoms was high in Phase 1 and significant, with no difference between the groups, whereas the treated and control groups differed in Phase 2. A comparison between Phases 1 and 2 showed that only the treated group presented a reduction in the severity of signs and symptoms. The study showed that using this protocol, it is possible to define the frequency and severity of symptoms as well as the effect of the treatment. The advantage of this protocol is that it would complement the data obtained using clinical examination with information provided by the patient in a measurable manner.
Cranio: the journal of craniomandibular practice 11/2006; 24(4):258-64. · 1.11 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This clinical report describes the diagnosis and treatment of a patient under emotional stress with orofacial pain, headaches, and the feeling of a foreign body in the throat. An elongated styloid process at the beginning of the oral pharynx was diagnosed. Although these symptoms could be aspects of Eagle's syndrome, deflective occlusal interferences, tender muscles of mastication, and a clicking temporomandibular joint led to an evaluation for temporomandibular disorder related to malocclusion. An occlusal splint was used to confirm the diagnosis and to alleviate symptoms. Occlusal adjustments were subsequently performed. In a 10-year follow-up, the patient had no complaints.
Journal of Prosthetic Dentistry 11/2003; 90(4):317-20. · 1.72 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Numerous implant systems exist that have the versatility to create a custom implant abutment with an anatomic shape. This clinical report describes the use of a digital scanner with CAD/CAM technology to create (copy mill) an anatomically shaped abutment.
Journal of Prosthetic Dentistry 07/2003; 89(6):536-9. · 1.72 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This work is a clinical case report of a patient presenting with marked tooth wear in all teeth, a reduction in the vertical dimension of occlusion, and fatigue in the muscles of mastication. The treatment proposed and effected used a muscle-relaxing appliance and mandibular and maxillary overlay appliances which were adjusted according to the occlusal contacts, vertical dimension of occlusion, and the mandibular positioning. The results obtained were satisfactory in terms of relaxing the muscles involved, reestablishing the dimensions of the lower third of the face, and the functional activities of deglutition, mastication, and speech.
Cranio: the journal of craniomandibular practice 02/2001; 19(1):61-4. · 1.11 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This report describes a case of arthrogryposis multiplex congenita and concomitant bruxism with limited mouth opening and pain in the temporomandibular joints (TMJ). A conservative treatment with a myorelaxing splint and physiotherapeutic exercises was prescribed resulting in improvement to the muscular and joint conditions and a reduction in pain.
Cranio: the journal of craniomandibular practice 02/2000; 18(1):66-70. · 1.11 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The authors report a clinical case that presented tooth wear and absence, with painful muscular and articular symptomatology, and also alteration in deglutition, mastication and speech. The clinical procedures used were re-establishment of vertical dimension of occlusion, mandibular centric relations, and occlusal contacts through therapeutic removable partial dentures. The condyle position was analyzed in habitual occlusion and in occlusion with dentures, through transcranial radiographs of the temporomandibular joints. Oral rehabilitation was achieved with dental restoration and removable partial dentures.
[Show abstract][Hide abstract] ABSTRACT: This work presents a case report of a woman, aged 62, who presented with signs and symptoms of temporomandibular disorder (TMD). The patient reported pain in the masticatory system and examination showed a reduction in the occlusal vertical dimension (OVD). She was treated with complete dentures incorporating a modification to the posterior regions developed by the authors and which were termed "sliding plates." Through analysis of photographs taken of the patient prior to the extraction of the patient's natural dentition, sliding plates were utilized to reestablish the OVD. The sliding plates also allowed for unrestricted eccentric mandibular movements, thereby accelerating the neuromuscular deprogramming and making it possible for the mandible to adopt a more physiologic position. The dentures reduced the pain and were well-accepted by the patient. Therefore, sliding plates may be of great benefit to completely edentulous patients with painful symptoms that result from alterations in the OVD and inappropriate condylar positioning.
Cranio: the journal of craniomandibular practice 11/1999; 17(4):289-92. · 1.11 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The authors studied the effect of a positioning orifice introduced in the anterior palatine region of occlusal splints for patients with craniomandibular disorders of swallowing and speech patterns. The patients were evaluated in four distinct situations. It was concluded that the splint orifice significantly favored swallowing and speech while the splint was being used, and is more comfortable for the patient.
[Show abstract][Hide abstract] ABSTRACT: We report a clinical case of Eagle's syndrome which required dental intervention due to the presence of exacerbated symptoms indicating an association with a temporomandibular disorder. The therapeutic dental procedures used were an occlusal splint and temporary removable partial dentures. Surgical removal of the styloid process on the left side was later performed as a medical option.