Examination of temporomandibular disorders in the orthodontic patient: a clinical guide

The possible association between orthodontic treatment and temporomandibular disorders (TMD) is a topic of great interest in the current literature. The true role of orthodontic therapy on the etiology of TMD, however, is still uncertain. From the clinical prospective, a thorough examination of the stomatognathic system is always necessary in order to detect possible TMD signs and symptoms prior to the beginning of the orthodontic therapy. Caution should be exercised when planning, performing and finalizing orthodontics, especially in patients who with history of signs and symptoms of TMD. The clinician must always eliminate patient's pain and dysfunction before initiating any type of orthodontic mechanics. Muscle incoordination, unstable disc-condyle relationship and bone alterations are usual TMD conditions that can interfere with the presenting occlusal relationship. This article reviews these aspects and presents a detailed clinical guide for the examination of the orthodontic patient, considering aspects related to facial pain and dysfunction

Anatomia cirúrgica do nervo maxilar na região zigomática

Anatomic knowledge on the zygomatic fossa is of primary importance to improve the regional anesthetic technique of the maxillary nerve. Few reports in the literature have addressed the trajectory of the maxillary nerve and its branches in this region; thus, this study aimed at presenting information about the trajectory of these nerves. Thirty human half-heads of both genders were fixed in 10% formalin and demineralized in 5% nitric acid, and the maxillary nerve was dissected since its origin on the pterygopalatine fossa until penetration into the inferior orbital fissure. It was observed that the maxillary nerve sends one to three posterior superior alveolar branches and tuberal descendent branches, which supply the soft tissue structures of the region. The posterior superior alveolar nerves are inferiorly oriented near the maxillary tuberosity, where they penetrate the alveolar canals with the posterior superior alveolar artery and send small nerve branches that continue in an extraosseous trajectory. This study found that nearly 2/3 of the trajectory of the maxillary nerve is located in the zygomatic region, with a short segment (1/3) in the pterygopalatine fossa.O conhecimento anátomo-cirúrgico da região zigomática é fundamental para o aprimoramento de técnicas anestésicas tronculares do nervo maxilar. A literatura pouco se refere à trajetória do nervo maxilar e seus ramos nessa região, portanto, o presente estudo tem como objetivo esclarecer o percurso desses nervos. Foram dissecadas ao microscópio cirúrgico MC900 (D.F.Vasconcelos), 30 hemicabeças humanas, de ambos os sexos, que foram previamente formolizadas a 10% e desmineralizadas em ácido nítrico a 5%. Observou-se que o nervo maxilar, desde sua origem na fossa pterigopalatina até penetrar na fissura orbital inferior, emite de um a três ramos alveolares superiores posteriores e ramos tuberais descendentes que vão para estruturas moles da região. Os nervos alveolares superiores posteriores, descem adjacentes à tuberosidade da maxila, na qual penetram através dos canais alveolares junto com a artéria homônima e podem emitir filetes nervosos que continuam trajeto extra-ósseo. Contrariando os achados da literatura, com este estudo observou-se que o nervo maxilar apresenta praticamente dois terços de sua trajetória na região zigomática e o restante na fossa pterigopalatina

Comparison of manual, digital and lateral CBCT cephalometric analyses

Objective: The aim of this study was to compare the reliability of three different methods of cephalometric analysis. Material and Methods: Conventional pretreatment lateral cephalograms and cone beam computed tomography (CBCT) scans from 50 subjects from a radiological clinic were selected in order to test the three methods: manual tracings (MT), digitized lateral cephalograms (DLC), and lateral cephalograms from CBCT (LC-CBCT). The lateral cephalograms were manually analyzed through the Dolphin Imaging 11.0™ software. Twenty measurements were performed under the same conditions, and retraced after a 30-day period. Paired t tests and the Dahlberg formula were used to evaluate the intra-examiner errors. The Pearson's correlation coefficient and one-way analysis of variance (ANOVA) tests were used to compare the differences between the methods. Results: Intra-examiner reliability occurred for all methods for most of the measurements. Only six measurements were different between the methods and an agreement was observed in the analyses among the 3 methods. Conclusions: The results demonstrated that all evaluated methodologies are reliable and valid for scientific research, however, the method used in the lateral cephalograms from the CBCT proved the most reliable

3-D Evaluation of temporary skeletal anchorage sites in the maxilla

The selection of temporary anchorage device (TAD) site can be a challenging task since one should not only consider the 2-D distances between roots, but also the entire 3-D space. Thus, the aim of this study was to evaluate the posterior maxillary regio

Estabilidade a longo prazo do tratamento da mordida aberta anterior na dentadura mista: relato de caso clínico

Apresentou-se um relato de caso clínico de mordida aberta anterior, tratada em dentadura mista, demonstrando uma das possíveis formas de tratamento, capaz de interferir no crescimento e redirecionar seus vetores. Os protocolos ortodônticos e ortopédicos utilizados foram a expansão lenta da maxila, utilizando grade palatina soldada a um expansor bihélice, com tração alta na mandíbula, num período diário de 16 horas. Oito anos de estabilidade foram alcançados, explicados pelo fato de o tratamento ter sido conduzido no momento oportuno do desenvolvimento, o que estabeleceu equilíbrio entre os músculos peribucais, em conjunto com o período final do crescimento. A combinação do tratamento ortodôntico e ortopédico foi necessária para se evitar a necessidade de tratamento cirúrgico.A clinical case with anterior open-bite, treated in the mixed dentition, is presented. This approach demonstrates one of the possible approaches of treatment, which is capable of interfering with growth and redirecting its vectors. Orthodontic and orthopedic methods were used, consisting of slow maxillary expansion, through a fixed palatal crib soldered in a bi-helix appliance, and high-pull traction on the mandible for 16 hours a day. After eight years of follow-up, stable outcomes were accomplished. These results may be explained by the fact that treatments were performed at the appropriate period of development, thus establishing perioral muscular equilibrium, matching the final period of facial growth. The combination of orthodontic and orthopedic treatments was necessary to prevent the need of further orthognathic surgery treatment

Update birds list of Santiago del Estero, Argentina

Este artículo presenta una actualización de la lista de aves de la provincia de Santiago del Estero (Argentina), que evalúa la residencia y distribución, y reporta el estado de conservación nacional de las especies. Las fuentes de registros de las aves corresponden a libros, artículos científicos, tesis, informes técnicos, colecciones de museos, páginas web y a las observaciones personales de los autores del presente artículo. La lista consiste de 387 especies de aves (26 órdenes y 61 familias), con 51 especies nuevas en referencia a la lista de 1991. Fueron determinadas 188 especies residentes, 64 migrantes estivales, 18 migrantes invernales, 2 migrantes de paso y 57 ocasionales. Los estados de conservación evidenciaron 1 especie En Peligro Crítico, 4 En Peligro, 7 Amenazadas, 21 Vulnerables, 348 No Amenazadas y 1 Insuficientemente Conocida. Se requiere reforzar los estudios de aves para definir las residencias de 58 especies, y para evaluar las situaciones actuales de las especies que no se registran desde hace más de tres décadas en la provincia.This paper presents an update to the bird list of Santiago del Estero province (Ar-gentina), which evaluates the occurrence and distribution and reports the national conservation status of the species found. The sources of bird records correspond to books, scientific articles, theses, technical reports, museum collections, web pages and the personal observations of the authors of this paper. The list consists of 387 bird species (26 orders and 61 families), with 51 new species regarding the 1991 list. From the species identified 188 were resident species, 64 summer migrants, 18 winter migrants, 2 passage migrants and 57 occasional. The conservation status showed 1 species Critically Endangered, 4 Endangered, 7 Threatened, 21 Vulnerable, 348 Not Threatened and 1 Insufficiently Known. It is necessary to reinforce the studies on birds to define the occurrence of 58 species, and to evaluate the current situations of the species not recorded for more than three decades.Fil: Coria, Oscar René. Universidad Nacional de Santiago del Estero. Facultad de Ciencias Forestales; Argentina. COA Kakuy; ArgentinaFil: Quiroga, Oscar Bernardo de Jesús. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo; Argentina. COA Kakuy; ArgentinaFil: Navarro, Jose Luis. Coa Kakuy; ArgentinaFil: Heredia, Javier. Ecosistemas Argentinos; ArgentinaFil: Torres, Ricardo Marcelo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Diversidad y Ecología Animal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto de Diversidad y Ecología Animal; Argentina. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Museo de Zoología; ArgentinaFil: Lima, Javier Jorge. Universidad Nacional de Santiago del Estero. Facultad de Ciencias Forestales; Argentin