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Bruxism is a frequent motor habit in the population, currently divided into awake and sleep bruxism. Temporomandibular disorders (TMD) are a group of condition that involves the chewing muscles, the TMJ and associated structures. Both concepts are often mistaken or misunderstood among health professionals and, thus, misdiagnosed and treated. The treatment of these disorders is still a matter of discussion by several health professionals, in view of their multidisciplinary character. Objvective: The aim of this article is to evaluate the knowledge about the concepts and treatment adopted by dentists and physiotherapists, as well as the interdisciplinary interaction between the two areas. Methods: The evaluation was made through a questionnaire and the data obtained was computed, compared and analyzed statistically. Results/conclusion: The study demonstrated that, despite understanding the importance of multidisciplinarity, there is still a lack of knowledge about possible treatment options and concepts. El bruxismo es una conducta motora frecuente en la población, actualmente dividida en bruxismo de vigilia y bruxismo del sueño. Los trastornos temporomandibulares (TTM) son trastornos que involucran los músculos de la masticación, la ATM y las estructuras asociadas. Ambos conceptos suelen confundirse entre los profesionales y, por tanto, son mal diagnosticados y tratados. El tratamiento de estos trastornos sigue siendo motivo de discusión por parte de varios profesionales de la salud, dado su carácter multidisciplinar. Objetivo: El objetivo de esta investigación es evaluar el conocimiento sobre los conceptos y el tratamiento adoptado por los odontólogos y fisioterapeutas, así como la interacción interdisciplinaria entre las dos áreas. Método: La evaluación se realizó a través de un cuestionario y los datos obtenidos fueron computados, comparados y analizados estadísticamente. Resultado/conclusión: El estudio mostró que, a pesar de comprender la importancia de la multidisciplinariedad, todavía hay una falta de conocimiento sobre los conceptos y las posibles opciones de tratamiento. O Bruxismo é um comportamento motor frequente na população, atualmente dividido em bruxismo da vigília e do sono. As disfunções temporomandibulares (DTM) são desordens que envolvem os músculos da mastigação, a ATM e estruturas associadas. Ambos os conceitos muitas vezes são confundidos entre os profissionais e, dessa forma, diagnosticados e tratados erroneamente. O tratamento dessas desordens ainda é motivo de discussão por diversos profissionais da área da saúde, tendo em vista seu caráter multidisciplinar. Objetivo: O Objetivo dessa pesquisa é avaliar o conhecimento acerca dos conceitos e tratamento adotados por dentistas e fisioterapeutas, assim como a interação interdisciplinar entre as duas áreas. Método: A avaliação foi feita através de um questionário e os dados obtidos computados, comparados e analisados estatisticamente. Resultado/conclusão: O estudo demonstrou que, apesar de entenderem a importância da multidisciplinaridade, ainda há falta de conhecimento sobre os conceitos e opções de tratamento possíveis.

Introdução: O queratocisto odontogênico é uma lesão cística intra-óssea que se origina do resto celular da lâmina dentária. Possui crescimento lento, assintomático e é comumente encontrado em radiografias de rotina. É mais prevalente no sexo masculino entre a 2ª e 3ª décadas de vida e acomete preferencialmente a mandíbula. Objetivo: relatar um caso de queratocisto em região anterior da maxila e realizar uma revisão dos tratamentos que estão disponíveis para essa lesão. Relato de caso: paciente do sexo feminino, 46 anos de idade, durante exame radiográfico de rotina, exibiu área radiolúcida unilocular com borda esclerótica definida que se estendia do dente 11 ao 24. No exame clínico não foi possível notar nenhuma expansão da cortical óssea. Foi realizada biópsia e instalado, no mesmo momento cirúrgico, dispositivo para descompressão da lesão. Após análise histopatológica e confirmação diagnóstica, a paciente foi submetida a enucleação cirúrgica. Conclusão: o paciente permanece em acompanhamento há 3 anos sem sinais clínicos ou radiográficos de recidiva da lesão.

Orientador: Marcelo Marotta Araújo Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba Resumo: O tratamento das fraturas mandibulares pode ser conservador ou cirúrgico. Dentre as complicações advindas do trauma e do tratamento das fraturas, destacam-se: comprometimento de vias aéreas, sangramento, perda ou danos aos dentes e osso alveolar, não-união, má-união, infecção, desordens temporomandibulares (especialmente em fraturas de côndilo), má-oclusão e lesões aos nervos, em especial ao alveolar inferior e mentual. O objetivo deste trabalho foi avaliar o grau de perda de sensibilidade e de recuperação do nervo alveolar inferior e mentual em pacientes vítimas de fraturas mandibulares, que foram submetidos ao tratamento cirúrgico. Foram avaliados 19 pacientes e 27 hemimandíbulas em 6 diferentes tempos: pré-operatório (T1) , pós-operatório de 1 semana (T2), pós-operatório de 1 mês (T3), pós-operatório de 3 meses (T4), pós-operatório de 6 meses (T5) e pós-operatório de 1 ano (T6). Para esta avaliação, foram utilizados métodos subjetivos e objetivos. Os subjetivos consistiram de um questionário com perguntas objetivas avaliando a perda de sensibilidade ao paciente. Para os testes objetivos foram demarcados 9 pontos em cada hemimandíbula. Cada um desses pontos foi analisado utilizando os filamentos de Semmes-Weinstein (estesiômetro), uma agulha de calibre 0,7mm e spray refrigerante. Foram feitos testes de sensibilidade dolorosa, sensibilidade tátil, sensibilidade térmica e de tração unidirecional. Para avaliar os resultados, foram utilizados os testes qui-quadrado para a hipótese de ausência de associação entre os indicadores de sensibilidade e as respostas do questionário e o teste de Cochran-Mantel e Haenszel para hipótese de igualdade. Todos os testes objetivos mostraram uma queda na sensibilidade no T2 estatisticamente significante (p < 0,0001) e uma melhora significativa após T4 (?

O Bruxismo é um comportamento motor frequente na população, atualmente dividido em bruxismo da vigília e do sono. As disfunções temporomandibulares (DTM) são desordens que envolvem os músculos da mastigação, a ATM e estruturas associadas. Ambos os conceitos muitas vezes são confundidos entre os profissionais e, dessa forma, diagnosticados e tratados erroneamente. O tratamento dessas desordens ainda é motivo de discussão por diversos profissionais da área da saúde, tendo em vista seu caráter multidisciplinar. Objetivo: O Objetivo dessa pesquisa é avaliar o conhecimento acerca dos conceitos e tratamento adotados por dentistas e fisioterapeutas, assim como a interação interdisciplinar entre as duas áreas. Método: A avaliação foi feita através de um questionário e os dados obtidos computados, comparados e analisados estatisticamente. Resultado/conclusão: O estudo demonstrou que, apesar de entenderem a importância da multidisciplinaridade, ainda há falta de conhecimento sobre os conceitos e opções de tratamento possíveis.

Study Design:Violence against women is a challenge in public health. It involves women of all ages, socioeconomic statuses, cultures, and religions.Objective:The objective of this study was to perform an epidemiological survey of facial trauma among women who experienced physical aggression by an intimate partner.Methods:Electronic medical records from a public tertiary referral hospital for trauma in the Brazilian state of Espírito Santo were analyzed between 2013 and 2018.Results:Patients were most commonly between 20 and 29 years of age (33.9%), and 50% of the patients were of mixed race. When separated by days of the week, facial trauma was most commonly inflicted on Sundays (24.2%) and on Saturdays (22.6%). Of the 62 women included in the study, 47 had facial fractures, and 7 had more than 1 concomitant fracture. Forty of the total fractures (72.7%) were on the middle and upper thirds of the face, while 15 fractures (27.3%) were on the lower third of the face. The most commonly observed signs and symptoms of these injuries were edema (56.5%), periorbital ecchymosis (35.5%), deviated nasal dorsum (22.6%), and hematoma (16.1%).Conclusions:Facial trauma may be considered an important marker of attempted femicide. Health care professionals must be aware of and attentive to this correlation, since many cases of attempted femicide go unnoticed or are attributed to another etiology.

The indications for impacted third molar extraction include the prevention of dental reabsorption on the adjacent tooth. Resorption can be classified as physiological (when deciduous teeth are exfoliated) or pathological (when caused by injury or irritation to the periodontal ligament). Many causes can trigger external root resorption (ERR), the most common cause of which is orthodontic forces. The most common cases of ERR involve impacted third molars which, due to the lack of space for their eruption, generate a greater chance of ERR on the distal portion of the second molar. This pathology is becoming progressively more frequent in clinical dental care. Periapical and panoramic radiographs are used to aid in diagnosis, as is cone beam computed tomography. In cone beam computed tomography scans, radiolucent areas with irregular gaps are detected; these gaps represent a significant loss of dental material. The objectives of this article were to report a case of second molar resorption triggered by an impacted third molar and to perform a review of the literature on the causes of external root resorption. Ideally, this information will aid dental clinicians (and orthodontists in particular) in understanding the features of this pathology so that they may recommend preventive third molar extraction when necessary.

Ameloblastoma is the most common odontogenic tumor; however, its occurrence in the maxilla is rare. Locally it shows infiltrative behavior and it has high rates of relapse. A 43-year-old male presented with an oral sinus communication after extraction of tooth #26. Oral examination revealed a 4-cm nodular lesion in the posterior region of the left superior vestibular sulcus, with an irregular surface and soft consistency. Computed tomography showed complete opacification as well as the destruction of the floor and the posterior wall of the left maxillary sinus. An incisional biopsy was performed and histopathologic examination revealed cords and islands of odontogenic epithelium embedded in a stroma with dense connective tissue. Basal cells showed cytoplasmic vacuolization and reverse polarization of the nuclei. The cells in the central region were loosely arranged and there were foci of cystic degeneration. After diagnosis of ameloblastoma, the lesion was enucleated and no recurrence was observed during follow-up.

Chondroblastoma is a rare and benign bone tumor that can occur in the craniofacial region. It may be difficult to diagnose using imaging alone; histological analyses and even immunohistochemical analyses are often required. This article reports on a rare case of chondroblastoma of the temporomandibular joint. Its diagnosis was hindered by its similarity to other tumors in both imaging exams and histological analyses. It was definitively treated through the total excision of the tumor. Keywords: Chondroblastoma, Temporomandibular joint, Immunohistochemical analyses

Local anesthesia is the most frequently performed procedure for all dentists and, despite their possible complications, often aspects such as dosage, contraindications and systemic effects are neglected. The objectives of this study are to evaluate prospectively the knowledge of undergraduate students for the technical, dosage and indication of local anesthetics in daily dental practice, in addition to clinical observation of possible complications from anesthesia. Questionnaires were distributed to students asking about the procedure undertaken, anesthetic volume used, because of the choice of the anesthetic, anesthetic dosage calculation, habit of relating the patient's weight dosage with the dosage being applied, habit of observing the reflux in cartridge in the anesthetic infiltration act and adverse effects on patients, type of anesthetic technique performed and expected time to onset of action of the drug. At the end of this study, we intend to be a greater awareness of students (undergraduates) about the systemic effects of local anesthetics in patients, and possibly decrease the expenses of the institution with excessive use of anesthetic cartridges arising from incorrect anesthetic technique. The vast majority of undergraduate students have no knowledge about the type of anesthesia to be used, the amount to be administered and the anesthetic action time. The awareness of students about the dosage of anesthetics and their systemic problems, reduces waste and the cost of the institution by the indiscriminate use of anesthetics, therebycontributing to improve the clinical management of students at graduation.

Objective: To evaluate cephalometrically the preoperative incisor inclination of 30 patients with Class II malocclusion, who were treated with mandibular advancement. Materials and Methods: Thirty immediate preoperative lateral cephalograms were photographed to be used in Dolphin Imaging Software. Linear and angular measurements were traced and analyzed. Each tracing was repeated twice with 1-week interval by the same operator. The measures were tabulated at Microsoft Excel and submitted to Student’s-t test and mean measures were compared with the normal values. The intraclass correlator coefficient was used to test the intraexaminer reliability. Results: The intraclass correlation coefficient was >0.9 and it featured a high reliability. Mean values of lower incisors differed from normal values, presenting labial inclination compared to normal values. Conclusion: In this study, the results showed that Class II patients that will be submitted a mandibular advancement (orthognathic surgery) had dental compensations and the lower incisors are more proclined comparing to the standard values. Keywords: Orthognathic surgery; Orthodontics; Cephalometry.

The treatment of mandibular angle fractures involves several postsurgical complications and is in greater demand when compared to therapeutic approaches for other types of mandibular fractures. Such postsurgical complications as bleeding, swelling, infection, dehiscence, pseudoarthrosis and paresthesia might affect individuals in both sexes and at all age groups. The presence of a mandibular third molar, a cross-sectional area thinner than the tooth-bearing region, and biomechanical forces might hamper the surgery, making it longer and more complex. Internal fixation is aimed at undisturbed healing under condition of functional and without any period of intermaxillary fixation. Adequate fixation depends on different fracture types, patients' general health and compliance, and the timing of the operation. This case report involves a mandibular angle fracture successfully treated with the lag screw technique, a simple approach to treat one of the most common fractures involving the mandible, quickly restoring the patient ́s oral functions.

Eagle’s syndrome is characterized by the symptoms of recurrent throat pain, pharyngeal foreign body sensation, dysphagia, referred otalgia, and neck pain. The treatment for Eagle´s syndrome can be pharmacologically, surgically, or both. The surgical management consists of two major procedures: the transoral approach or the extraoral–cervical approach. A 64-year-old patient with a severe cervical pain on the left side was evaluated with no defined diagnosis. During physical examination, an elongated styloid process could be palpated and with CT scan image, the Eagle´s syndrome diagnosis was done. The patient was successfully submitted to surgical resection of the elongated styloid process on the left side by an extraoral–cervical approach. After 6 months follow-up, the patient referred no symptom after the surgical treatment. The extraoral/cervical approach is a safe alternative that achieves adequate treatment of Eagle’s syndrome.

El uso de tecnologia de prototipado rapido en Cirugia Oral y Maxilofacial se ha incrementado en la ultima decada, lo que permite la gestion de los biomodelos de procesamiento de imagenes medicas, como tomografia computarizada para obtener un modelo tridimensional con las mismas caracteristicas geometricas del virtual. El objetivo de este estudio es presentar el uso de biomodelos para el tratamiento de las secuelas de un traumatismo maxilofacial con la evaluacion de las historias clinicas en un periodo que varia entre enero de 2000 a diciembre de 2010. Para el diagnostico y la planificacion de la cirugia maxilofacial de las secuelas en este periodo, 15 prototipos fueron utilizados, lo que permite determinar la planificacion del tratamiento con mas precision y para ahorrar tiempo de quirofano.

Mandibular dislocations present with frequency; when they are recurrent and sustained over time, surgical treatment is indicated. Although different therapeutic techniques exist, the eminectomy is one of the most often applied. In this investigation, 3 cases are described where the bilateral eminectomy was performed for recurrent mandibular dislocation with 5 years of duration. No dislocation recurrence, postoperative pain, or functional alterations were observed in any of the patients. The bilateral eminectomy is a well-known procedure described in the literature, with good scientific support and constant modifications to optimize its indications and results. Compared with the results from other investigations, it is concluded that treatment with a bilateral eminectomy can be applied safely in cases of recurrent mandibular dislocations.

This present study’s purpose is to evaluate the degree of paresthesia and recovery of inferior alveolar nerve in patients with mandible fractures who underwent surgical treatment. Nineteen patients were evaluated (27 hemimandibles) at six different times: preoperative (T1), postoperative 1 week (T2), postoperative 1 month (T3), postoperative 3 months (T4), postoperative 6 months (T5), and postoperative 1 year (T6). Subjective and objective methods were used for this evaluation. The results were analyzed using likelihood ratio chi-square test for the hypothesis of no association between indicators of sensitivity and responses to the questionnaire, and the Cochran–Mantel–Haenszel test for equality hypothesis. All objective tests showed a statistically significant worsening in sensitivity at T2 (p

Orientador: Marcelo Marotta Araújo Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba Resumo: Análises cefalométricas constituem um importante passo no planejamento pré-operatório de cirurgias ortognáticas. A partir da década de 80, traçados cefalométricos digitais foram incorporados e tornaram-se populares entre ortodontistas e cirurgiões. O Dolphin Imaging Software® (Chatsworth, California) é um dos programas computacionais mais comumente utilizados em todo o mundo para fins de planejamento e previsão do resultado pós-operatório. Para a análise cefalométrica, é necessária a digitalização de teleradiografias de perfil. Este trabalho, dividido em três capítulos, analisou no Dolphin Imaging Software: 1) se há diferença nas imagens digitalizadas por câmeras digitais ou scanners para uso neste programa 2) a inclinação ântero-posterior de incisivos centrais superiores e inferiores no pré-operatório imediato de pacientes Classe II de Angle submetidos à cirurgia de avanço mandibular e; 3) a recidiva de cirurgias de avanço maxilar em pacientes Classe III de Angle nos quais um cimento de fosfato de cálcio foi utilizado como material de enxertia. Para a realização do primeiro estudo foram utilizadas 10 teleradiografias de perfil escaneadas e fotografadas. Traçados cefalométricos foram realizados e medidas lineares e angulares foram analisadas. Os testes t-Student e Wilcoxon foram aplicados e concluiu-se que ambos os métodos podem ser utilizados para a digitalização das imagens, sem diferenças estatisticamente significantes entre os mesmos. O segundo estudo utilizou 30 teleradiografias de perfil de pacientes Classe II no pré-operatório imediato de cirurgias de avanço mandibular. Foram realizados os traçados digitais e a inclinação dos incisivos superiores e inferiores foi analisada por meio de medidas angulares e lineares. Após aplicados os testes estatísticos (t Student), concluiu-se que os incisivos inferiores, em sua maioria, estavam compensados, ou seja, demonstravam uma inclinação mais vestibular, enquanto que os incisivos superiores estavam dentro das medidas consideradas ideais, tratando-se de descompensação dentária. Por fim, o último estudo avaliou a recidiva do movimento de avanço de maxila em 8 pacientes Classe III em que um cimento de fosfato de cálcio foi utilizado como material de enxertia. Foram realizados os traçados cefalométricos das radiografias pré-operatórias e pós-operatórias imediatas e tardias e medidas lineares e angulares que ditam o posicionamento maxilar foram avaliadas. Após realizado o teste estatístico de Tukey (ANOVA), pode-se concluir que apenas em 1 medida foi observada recidiva do movimento, podendo esta técnica ser considerada estável Abstract: Cephalometric analyzes are an important step in preoperative planning of orthognathic surgery. From the 80's, digital cephalometric tracings were incorporated and became popular among orthodontists and surgeons. Dolphin Imaging Software (Chatsworth, California) is one of the computer programs most commonly used worldwide for planning purposes and forecasting the postoperative result. For cephalometric analysis is needed to digitize cephalometrics radiographs. This study was divided in three chapters, analyzed at Dolphin Imaging Software: 1) whether there are differences in the scanned images by digital cameras or scanners for use in this program, 2) the anteroposterior inclination of the upper and lower central incisors in the immediate preoperative patients with Angle Class II underwent mandibular advancement surgery and 3) relapse of maxillary advancement surgery in patients with Class III malocclusion in which a calcium phosphate cement was used as grafting material. For the first study were used 10 cephalometric radiographs scanned and photographed. Cephalometric tracings were performed, and linear and angular measurements were analyzed. The Student t test and Wilcoxon was applied and was concluded that both methods can be used for the digitization of images without statistically significant differences between them. The second study used 30 immediate preoperative cephalometric radiographs of Class II patients that were submitted to mandibular advancement surgery. Digital tracings were made and the inclination of the upper and lower incisors was analyzed by means of angular and linear measurements. After applied the statistical tests (Student t test), it was concluded that the lower incisors were mostly compensated, showing a labially inclination while the upper incisors were at the "ideal" position. Finally, the last study examined the relapse of maxillary advancement surgery of 8 Class III patients where calcium phosphate cement was used as a grafting material. We carried out the cephalometric analysis of radiographs of preoperative and postoperative early and late, and linear and angular measurements that dictate the maxillary positioning were evaluated. After performing the Tukey statistical test (ANOVA), it was concluded that although in one measure relapse were observed this is an effective method to decrease relapse in maxillary orthognathic surgery Doutorado Cirurgia e Traumatologia Buco-Maxilo-Faciais Doutora em Clínica Odontológica

INTRODUÇÃO: a hiperatividade condilar é uma condição causada por um desequilíbrio nos fatores de crescimento ósseo, gerando assimetrias faciais. Pode ser classificada em três tipos diferentes: hiperplasia hemimandibular (HH), alongamento hemimandibular (AH) e uma forma híbrida. O diagnóstico correto dessas hiperatividades é imprescindível, pois a abordagem é diferente para cada tipo de anomalia, tendo como opções o tratamento ortocirúrgico e a condilectomia alta. OBJETIVO: o objetivo desse artigo é, por meio de dois casos clínicos de assimetria facial causada por hiperatividade condilar, mostrar a importância de um correto diagnóstico e os meios utilizados para a obtenção do mesmo, visando um tratamento adequado para cada caso. INTRODUCTION: Condylar hyperactivity is a condition triggered by an imbalance in bone growth factors, which causes facial asymmetry. It can be classified into three different types: hemimandibular hyperplasia (HH), hemimandibular elongation (HE) and a hybrid form. It is essential that a correct diagnosis of these hyperactivities be reached since each type of anomaly requires a different approach. Treatment options include surgery and high condylectomy. OBJECTIVES: The purpose of this article is to present two cases of facial asymmetry caused by condylar hyperactivity, showing the importance of an accurate diagnosis and the means used to achieve it while seeking an appropriate treatment for each case.

Purpose Compare the traditional method of mounting dental casts on a semiadjustable articulator and the new method suggested by Wolford and Galiano, 1 analyzing the inclination of maxillary occlusal plane in relation to FHP. Materials and Methods Two casts of 10 patients were obtained. One of them was used for mounting of models on a traditional articulator, by using a face bow transfer system and the other one was used to mounting models at Occlusal Plane Indicator platform (OPI), using the SAM articulator. After that, na analysis of the accuracy of mounting models was performed. The angle made by de occlusal plane and FHP on the cephalogram should be equal the angle between the occlusal plane and the upper member of the articulator. Results The measures were tabulated in Microsoft Excell ® and calculated using a 1-way analysis variance. Statistically, the results did not reveal significant differences among the measures. Conclusion OPI and face bow presents similar results but more studies are needed to verify its accuracy relative to the maxillary cant in OPI or develop new techniques able to solve the disadvantages of each technique.

Odontogenic myxoma (OM) is an uncommon benign tumor with aggressive and invasive behavior. Predominant symptoms are usually slow and painless swelling, sometimes resulting in perforation of the cortical borders of the affected bone. In this paper, a case report of a patient with an OM on the right maxillary sinus and a vertical excess of maxilla will be presented. The treatment chosen was tumor resection in association with orthognathic surgery with biomodels assessment for surgical planning. A 3-year follow-up showed disease free and stability of the new position of maxilla. The international literature is evaluated to discuss this case report.

Orientadores: Marcelo Marotta Araújo, Roger William Fernandes Moreira Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba Resumo: O propósito no estudo foi avaliar comparativamente, através de teste de carregamento linear e análise fractográfica, duas marcas de material de fixação interna estável com dois métodos de fixação em fraturas simuladas em corpo de hemimandíbulas de alumínio. O trabalho foi dividido em dois grupos: Grupo I com duas estruturas de alumínio semelhantes à hemimandíbulas e fixação com duas placas de titânio de quatro furos do sistema 2,0mm, sendo uma placa na zona de compressão e outra zona de tensão, totalizando 20 placas de titânio; e grupo II, com duas estruturas de alumínio semelhantes à hemimandíbulas e fixação de uma placa de titânio de quatro furos do sistema 2,0mm na zona neutra de corpo de mandíbula, totalizando 10 placas de titânio. Testes de carregamento linear foram realizados por meio da máquina para ensaio universal mecânica Instron®, até a fratura do material. Após os testes, foram realizadas as análises fractográficas das superfícies de fratura dos materiais de fixação (grupos I e II) através de microscópio eletrônico de varredura FEI®, com o objetivo de analisar orientações, texturas e falhas dos materiais. Médias e desvio padrão das cargas e deslocamentos foram avaliados aplicando-se a Análise de Variância (ANOVA) two-way e teste de Tukey em nível de significância de 5%. Os resultados mostraram que o método de fixação com duas placas retas de quatro furos apresentou maior resistência à carga (p