RESUMO
Quantifying in edentulous patients the facial collapse and whether complete conventional denture (CCD) and implant-supported fixed complete denture (ISFCD) can restore the facial proportions to match those of a dentate patient (CG) is relevant for clinical dentists. One hundred and four participants were enrolled and divided into edentulous (n=56) and CG (n=48). The edentulous participants were rehabilitated with CCD (n=28) or ISFCD (n=28) in both arches. Anthropometric landmarks in the face were marked and captured by stereophotogrammetry. Linear, angular, and surface measurements were analyzed and compared among groups. The statistical analysis was performed by an independent t-test, the one-way ANOVA, and Tukey's test. The significance level was set at 0.05. The facial collapse was quantified as a significant shortening of the lower third of the face affecting facial aesthetics in all parameters evaluated and the same was observed in comparison among CCD, ISFCD, and CG. The CCD presented statistical differences with the CG group in the lower third of the face and labial surface, and the ISFCD showed no statistical differences with the CG and CCD. The facial collapse in edentulous patients could be restored through oral rehabilitation with an ISFCD similar to those of dentate patients.
Assuntos
Implantes Dentários , Arcada Edêntula , Boca Edêntula , Humanos , Adulto , Arcada Edêntula/reabilitação , Prótese Total , Prótese Dentária Fixada por ImplanteRESUMO
The study investigated whether chronic TMD patients with disc displacement with reduction (DDR), performing non-assisted maximum jaw movements, presented any changes in their mandibular kinematics with respect to an age-matched control group. Moreover, it was examined whether jaw kinematics and a valid clinic measure of oro-facial functional status have significant associations. Maximum mouth opening, mandible protrusion and bilateral laterotrusions were performed by 20 patients (18 women, 2 men; age, 18-34 years) and 20 healthy controls (17 women, 3 men; age, 20-31 years). The three-dimensional coordinates of their mandibular interincisor and condylar reference points were recorded by means of an optoelectronic motion analyser and were used to quantitatively assess their range of motion, velocity, symmetry and synchrony. Three functional indices (opening-closing, mandibular rototranslation, laterotrusion - right and left - and protrusion) were devised to summarise subject's overall performance, and their correlation with the outcome of a clinical protocol, the oro-facial myofunctional evaluation with scores (OMES), was investigated. TMD patients were able to reach maximum excursions of jaw movements comparable to healthy subjects' performances. However, their opening and closing mandibular movements were characterised by remarkable asynchrony of condylar translation. They had also reduced jaw closing velocity and asymmetric laterotrusions. The functional indices proved to well summarise the global condition of jaw kinematics, highlighting the presence of alterations in TMD-DDR patients, and were linearly correlated with the oro-facial functional status. The jaw kinematic alterations seem to reflect both oro-facial motor behaviour adaptation and a DDR-related articular impairment.
Assuntos
Imageamento Tridimensional , Côndilo Mandibular/fisiopatologia , Transtornos da Articulação Temporomandibular/fisiopatologia , Articulação Temporomandibular/fisiopatologia , Adolescente , Adulto , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Côndilo Mandibular/diagnóstico por imagem , Radiografia , Amplitude de Movimento Articular , Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Adulto JovemRESUMO
To compare the three-dimensional changes occurring in the maxillary arch during the use of modified pre-surgical nasoalveolar moulding (PNAM) and Hotz's plate. A clinical trial including 32 children with unilateral cleft lip and palate (UCLP), 16 treated with Hotz's plate and 16 with PNAM, was performed. Impressions of the maxillary arches were taken: A. prior to pre-surgical orthopaedics, B. before cheiloplasty and C. after cheiloplasty. Models were digitised using a stereophotogrammetric instrument, and geodesic distances were calculated: anterior, canine and posterior widths of the arch, and lengths and cleft depths of the larger and shorter segments. The time and treatment effects were assessed by two-factor anova. A significant effect of treatment was found for cleft depth at the larger segment: children treated with Hotz's plate had significantly deeper cleft than children treated with PNAM. All distances significantly changed during time: the anterior and canine widths decreased, while the posterior width, the lengths and depths of the cleft segments increased. Significant treatment per time interactions was found. The anterior and canine widths reduced more with PNAM between time points A and B while Hotz's treatment was more effective between B and C. The shorter segment depth increased more between B and C with PNAM, and between A and B with Hotz's plate. During pre-surgical orthopaedics, therapy with PNAM obtained the best results in reducing the width at the anterior segment of the cleft. This treatment gave a lower increase in cleft depth than treatment with Hotz's plate.
Assuntos
Processo Alveolar/cirurgia , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Procedimentos Ortopédicos/métodos , Obturadores Palatinos , Humanos , Imageamento Tridimensional , Lactente , Fotogrametria , Resultado do TratamentoRESUMO
The determination of normal parameters is an important procedure in the evaluation of the stomatognathic system. We used the surface electromyography standardization protocol described by Ferrario et al. (J Oral Rehabil. 2000;27:33-40, 2006;33:341) to determine reference values of the electromyographic standardized indices for the assessment of muscular symmetry (left and right side, percentage overlapping coefficient, POC), potential lateral displacing components (unbalanced contractile activities of contralateral masseter and temporalis muscles, TC), relative activity (most prevalent pair of masticatory muscles, ATTIV) and total activity (integrated areas of the electromyographic potentials over time, IMPACT) in healthy Brazilian young adults, and the relevant data reproducibility. Electromyography of the right and left masseter and temporalis muscles was performed during maximum teeth clenching in 20 healthy subjects (10 women and 10 men, mean age 23 years, s.d. 3), free from periodontal problems, temporomandibular disorders, oro-facial myofunctional disorder, and with full permanent dentition (28 teeth at least). Data reproducibility was computed for 75% of the sample. The values obtained were POC Temporal (88.11 +/- 1.45%), POC masseter (87.11 +/- 1.60%), TC (8.79 +/- 1.20%), ATTIV (-0.33 +/- 9.65%) and IMPACT (110.40 +/- 23.69 microV/microV.s %). There were no statistical differences between test and retest values (P > 0.05). The Technical Errors of Measurement (TEM) for 50% of subjects assessed during the same session were 1.5, 1.39, 1.06, 3.83 and 10.04. For 25% of the subjects assessed after a 6-month interval, the TEM were 0.80, 1.03, 0.73, 12.70 and 19.10. For all indices, there was good reproducibility. These electromyographic indices could be used in the assessment of patients with stomatognathic dysfunction.
Assuntos
Eletromiografia/métodos , Músculos da Mastigação/fisiologia , Contração Muscular/fisiologia , Brasil , Oclusão Dentária , Eletromiografia/normas , Feminino , Humanos , Masculino , Valores de Referência , Reprodutibilidade dos Testes , Adulto JovemRESUMO
The objective of the study was to analyse quantitatively palatal morphology in bruxist and non-bruxist children with mixed dentition. Twenty-three children with mixed dentition were classified as bruxist according to their anxiety level, audible occlusal sounds related by the parents and signs of temporomandibular disorders; 23 children were control subjects matched for gender, age, and dental formula. The maxillary dental arches of all subjects were reproduced from alginate impressions cast in dental stone with a standardized technique. The casts were digitalized and mathematical equations were used to obtain the form of the palate in the sagittal, frontal and horizontal planes. Bruxist children had a statistically significant longer palate in the sagittal plane than control children; palatal shape differed especially in correspondence of the third, fourth and fifth teeth, bruxist children showing a relatively higher palate than control children. In this pilot study, sagittal plane differences in the palate between bruxist and non-bruxist children matched for age and gender were found. Further investigations are needed to understand better the clinical implications of the findings. Results should be taken into account in the diagnosis of the occlusal development in children with parafunctions to prevent future abnormalities: a bruxist child may have bigger dental arches than a normal child.
Assuntos
Bruxismo/patologia , Palato/patologia , Bruxismo/diagnóstico , Bruxismo/fisiopatologia , Estudos de Casos e Controles , Criança , Simulação por Computador , Arco Dental/patologia , Dentição Mista , Feminino , Humanos , Masculino , Modelos Anatômicos , Palato/crescimento & desenvolvimento , Projetos PilotoRESUMO
Race and ethnicity influence the form of the human craniofacial complex in varying ways. The aim of the present investigation was to quantify the effects of ethnicity (mestizos, Aymara, non-Aymara), age (adolescents and adults), and sex on the form (size and shape) of the hard palate in normal Native American individuals. From the dental casts of 51 individuals with a complete permanent dentition, the x, y, and z coordinates of several standardized palatal landmarks were obtained with a computerized 3-dimensional digitizer. Palatal landmarks were used to derive a mathematical equation for palatal shape in the frontal and sagittal planes. Palatal width and length, frontal and sagittal heights, sagittal slope, and deviation of the raphe from the midline were also calculated. In the Aymara subjects, there was no effect of sex on palatal size, but there was an effect on palatal shape independent of size, especially with respect to male growth. Indeed, female palates apparently did not change their shape between adolescence and adulthood, while male palates increased their posterior "height." Overall, the 3 ethnic groups appeared to possess similar palatal size, with small significant differences. In the adult individuals, ethnicity did not seem to influence palatal shape. In contrast, adolescent males showed differences: non-Aymara subjects had the "highest" palatal shape, Aymara the "lowest," and mestizos an intermediate position. In conclusion, ethnicity does not seem to be a factor of major variability of human hard palate morphology, at least in the present 3 northern Chilean groups, as already found for dental arch shape. Age probably has a larger effect, particularly in the posterior part of the palate, where the eruption of the second and third molars between adolescence and young adulthood may play a role. A further development of the present investigation may involve larger samples of individuals from different ethnic groups.
Assuntos
Indígenas Sul-Americanos/genética , Desenvolvimento Maxilofacial/genética , Palato Duro/anatomia & histologia , Adolescente , Adulto , Fatores Etários , Análise de Variância , Chile , Feminino , Variação Genética , Humanos , Análise dos Mínimos Quadrados , Masculino , Fatores Sexuais , População Branca/genéticaRESUMO
Race and ethnicity variably influence the form of the human craniofacial complex. In the present study, the effects of ethnicity and sex on the global size of normal adult dental arches were analyzed. The dental arches of 47 northern Chilean mestizos (25 men, 22 women) and 95 northern Italian Caucasians (50 men, 45 women) were cast in stone. All subjects had a complete dentition in both arches. In all models the coordinates of dental cusp tips were digitized using an image analyzer. The center of gravity of each tooth was computed and arches were interpolated using a polynomial model (y = ax + bx2 + cx3 + dx4). In all arches, the intercanine, intermolar, and mid-intercanine to mid-intermolar distances were computed from the dental centers of gravity. These arch distances were entered in a linear discriminant function analysis. The polynomial model accurately interpolated data points in all instances, and most of the dental arch form was determined by the first and second degree coefficients. On average, Italian Caucasian arches were smaller than Chilean mestizo arches. Male mean distances were larger than female distances regardless of ethnic group or arch. The linear discriminant analysis performed between male and female arches within ethnic groups was significant only for both Italian Caucasian arches, but the percentage errors for the classification of a new individual were very high (about 30%). Conversely, Italian Caucasian arches could always be discriminated from Chilean mestizo arches of the same sex with a much smaller error.