Rare anatomical variation related to the nasopalatine canal

The nasopalatine canal is a relatively long narrow structure located in the midline of the maxilla that contains the nasopalatine nerve and terminal branch of the descending palatine artery. Anatomical variations related to this structure have been reported. This article aimed to report a case of a complete additional nasopalatine canal on a 53-year-old female patient who underwent an examination by cone beam computed tomography. On sagittal slices, it was possible to observe the presence of an additional canal anterior and superior to the nasopalatine canal, separated by a bony septum. Each canal extended from independent superior openings (located in the nasal cavity) to independent openings located in the remaining alveolar process of the anterior maxilla. Identification of individual anatomical variations, especially involving neurovascular structures, plays an important role in the successful outcomes of surgical procedures involving the anterior maxilla.359SI85385

Osteochondritis dissecans of the temporomandibular joint

A case is reported of a 43-year-old female patient presenting bilateral osteochondritis dissecans (OCD) of the temporomandibular joint (TMJ), in different stages for each side, associated with avascular necrosis (AVN) of the right condyle. Additionally observed was anterior disk displacement without reduction for both sides. We have proposed an adaptation of the previous classification of OCD for cases affecting, the TMJ. We have also stressed the fundamental role of panoramic radiography on the diagnosis of stage 3 and stage 4 OCD of the TMJ. In relation to MRI, we have recommended sagittal (slice thickness of 2 mm) and coronal (slice thickness of I mm) fast spin-echo proton density-weighted sequences to better identify bone lesions (stage I and 2) and also localize osteochondral loose bodies; and coronal (slice thickness of I mm) fat-suppressed fast spinecho T-2 weighted sequence to better evaluate OCD (stable or unstable) and the features of the occasionally associated AVN (acute or chronic).o TEXTO COMPLETO DESTE ARTIGO, ESTARÁ DISPONÍVEL À PARTIR DE AGOSTO DE 2015.34319319

Temporomandibular joint disc adhesion without mouth-opening limitation

66355155

Voz e disfunção temporomandibular em professores Voice and temporomandibular joint disorders in teachers

OBJETIVO: verificar a presença e possível correlação entre alteração vocal e DTM, em professores, a partir de dados de avaliação autorreferida, fonoaudiológica, otorrinolaringológica e odontológica. MÉTODOS: participaram deste estudo, 29 professores de uma escola de rede pública do ensino fundamental e médio do município de Sorocaba - SP. Os professores responderam questionário para levantamento de alteração vocal, e de disfunção temporomandibular (DTM). Foram realizadas quatro avaliações: perceptivo-auditiva; otorrinolaringológica; motricidade orofacial e odontológica. A menção a três ou mais sintomas no questionário determinou "presença" de queixa de voz e de DTM. As avaliações: perceptivo-auditiva e otorrinolaringológica concluíram a "ausência" e "presença" de alteração de voz e de laringe. Nas avaliações da motricidade orofacial e odontológica foi considerada DTM quando registrados três ou mais sinais e/ou sintomas, sendo indispensável à presença de dor. Na análise estatística dos dados, foram empregados: teste de Igualdade de Duas Proporções, teste exato de Fisher e de concordância Kappa. RESULTADOS: dentre os participantes, 82,8% fizeram autorreferência à alteração vocal e 62,1% de sintomas de DTM; 51,7% apresentaram alteração de voz na avaliação otorrinolaringológica e 65,5%, alteração de DTM na avaliação odontológica. Na comparação da avaliação de alteração de voz e DTM foi registrada correlação significante presente na avaliação perceptivo-auditiva da voz e de motricidade orofacial para DTM, e com tendência a significância na aplicação do questionário. CONCLUSÃO: os resultados apontam na direção de confirmar a presença de alteração de voz e DTM no grupo de professores pesquisado e correlação entre os mesmos.<br>PURPOSE: to check the presence and possible correlation between vocal disorders and temporomandibular joint disorders (TMJD) in teachers, from self-reported speech pathological, medical and dental evaluation data. METHODS: 29 public school teachers from the city of Sorocaba - SP took part in this study. The teachers filled out a questionnaire about vocal disorders and on TMJD. The four following assessments were performed: auditory-perceptive, ENT medical assessment, oral-facial mobility, and a dental assessment. The mentioning about three or more symptoms in the questionnaire determined 'presence' of vocal and TMJD complaint. Both auditory-perceptive and ENT evaluations concluded whether there was 'presence' of voice and laryngeal disorders. TMJD was considered present when three or more signs or symptoms, necessarily including pain, were registered during oral-facial mobility and dental assessments. For statistical analysis of the data the following tests were applied: Two Proportions Equality Test, Fischer's Exact Test and Kappa Agreement Test. RESULTS: among the participating subjects, 82.8% reported having a vocal disorder, and 62.1% reported TMJD symptoms; 51.7% showed vocal disorders in ENT evaluation, and 65.5% had TMJD according to dental assessments. When comparing vocal and TMJ disorder assessments, a significant correlation was present for auditory-perceptual and oral-facial mobility for TMJD, with a tendency towards significance also when applying the questionnaire. CONCLUSION: the results point towards confirming the presence of TMJ and vocal disorders in the group of teachers in this research, as well as positive correlations between these two disorders