Abstract  Aim: The aim of this study was to evaluate the effects of the structured implementation of screening and diagnostics of orofacial pain and jaw function in the affiliated general dentistry clinics of FTV VGR. Furthermore, evaluate differences in treatment between patients with and without a dental care subscription.   Material and method: Data regarding TMD treatments (600-series treatments) performed every month were gathered from the affiliated clinics over a 24-month timespan stretching between 2019-2021. Each treatment code was divided into three categories, all patients, patients with dental care subscription and patients without a dental care subscription. Parametrical statistics were used to assess the change of each treatment code performed before compared to after the implementation of Brief DC/TMD. The student's paired t-test was used and a probability level of P<0.05 was considered significant.    Results: The proportion of patients that received treatments and number of treatments performed saw a significant increase after the implementation project. Each specific treatment within the 600-series increased except for 604 (soft occlusalt splint) and 607 (occlusal adjustment) which decreased. Among the three treatments that increased, two were significant: 601, hard acrylic maxillary occlusal splint and 606, jaw exercises. Patients with a dental care subscription received TMD-treatment in a significantly higher degree.    Conclusion: The present study indicates that the implementation of Brief DC/TMD increased diagnostics and treatment of TMD within the general dentistry practice of Folktandvården Västra Götaland during the analysed time periods. Further research is needed to determine the cause behind the performance disparities among the individual clinics. / Sammanfattning Syfte: Att utvärdera effekten av en strukturerad implementation av screening och diagnostik av orofacial smärta och käkfunktion inom Folktandvården Västra Götalands tandvårdskliniker. Samt jämföra patienter med och utan Frisktandvård. Material och metod: Data gällande behandling av bettfysiologiska besvär (600-serie åtgärdskoder) samt undersökningar utförda varje månad var samlade från de 118 anslutna klinikerna under en 24-månadersperiod som varade mellan 2019–2021. Varje parameter delades upp i tre kategorier, alla patienter, patienter med Frisktandvård och patienter utan Frisktandvård. Parametrisk statistik användes för att bedöma förändringarna som utfördes före jämfört med efter implementationen av kort DC/TMD. Students parade t-test användes för att beräkna signifikansen av de observerade förändringarna där ett P-värde <0,05 ansågs signifikant. Resultat: Andelen patienter som fick behandling och antalet utförda behandlingar som en helhet såg en signifikant ökning efter implementationsprojektet i jämförelse med före (procentuell skillnad på 46,8% respektive, 56,5%). Varje enskild behandling inom 600-serien såg en ökning, förutom kod 604 (mjukplastskena) och 607 (bettslipning för ocklusal stabilisering) vilket minskade. Bland de tre behandlingarna som såg en ökning, var två signifikanta: 601 (Bettskena i hård akrylat i överkäken, utförd på bettfysiologisk indikation) samt 606, (motorisk aktivering). Patienter med Frisktandvård fick behandling mot sina bettfysiologiska besvär i en signifikant högre grad. Slutsats: Denna studie indikerar att implementation av kort DC/TMD ökade diagnostik och behandling av TMD inom Folktandvården Västra Götaland under de analyserade tidsperioderna. Vidare forskning behövs för att utvärdera orsaken bakom prestationsskillnaderna mellan de individuella klinikerna.

No description available.

Bei CMD-Erkrankungen handelt es sich um Kraniomandibuläre Dysfunktionen, die Schmerzen und/oder spezifische Funktionsstörungen umfassen. Sie gelten als Erkrankungen, die sich aus mehreren Symptomen zusammensetzen können. Kardinalsymptome sind Schmerzen im Bereich der Kiefergelenke und der Kaumuskulatur, Einschränkungen der Unterkieferbeweglichkeit sowie intraartikuläre Störungen. CMD-Erkrankungen erlangen stetig größer werdende Bedeutung in der Zahnheilkunde. Immer häufiger stehen Zahnärzte Patienten gegenüber, die über wiederkehrende oder chronische Schmerzen der Kaumuskulatur sowie der Kiefergelenke berichten. Diese sind gleichzeitig der Hauptgrund für eine aktive Behandlungssuche. Etwa 10 % der Allgemeinbevölkerung, vorzugsweise Erwachsene, weisen Symptome einer CMD auf. Folglich wächst die Bedeutung eines zuverlässigen Diagnostikinstrumentes für die frühzeitige Feststellung von Funktionsstörungen und behandlungsbedürftiger CMD. Allein in Deutschland existiert eine Vielzahl von Anamnese- und Befunderhebungssystemen. Fehlende Standardisierungen von Diagnose- und Untersuchungskriterien können in hohem Ausmaß zur Über-, Unter- und Fehldiagnostik bei CMD-Erkrankungen führen und die Folge von hohen Behandlungskosten sein. Mittels Instruktionsvideos können praktische Abläufe und Untersuchungstechniken standardisiert dargestellt und die Erlernbarkeit verbessert werden. Sie können somit ein visuelles, zuverlässiges Fundament der CMD-Diagnostik bilden. Die Instruktionsvideos sollen dabei die Durchführung der standardisierten klinischen Untersuchung anhand der DC/TMD-Richtlinien veranschaulichen. Die vorliegende Arbeit beinhaltete die Evaluation der Anwendung des DC/TMD-Lehrvideos in Verknüpfung mit dem deutschen Manual für das Erlangen von klinischen Kompetenzen. Im Rahmen der randomisierten Studie nahmen in der Gesamtheit 50 Zahnmedizinstudierende der Universität Leipzig teil, die sich in ihrem dritten Ausbildungsjahr befanden. Das Studienprotokoll wurde durch die örtliche Ethikkommission (208/19-ek) genehmigt und alle teilnehmenden Studierenden gaben ihre Einwilligung. Die Aufteilung in zwei Gruppen erfolgte zufällig, nach Geschlecht stratifiziert. Es erfolgte die Überprüfung ihrer klinischen Fähigkeiten für die Untersuchung von Patienten bei Verdacht auf kraniomandibuläre Dysfunktionen noch vor Beginn des ersten klinischen Kurses. Als Testverfahren wurde eine dreistufige OSCE entwickelt, welche die sachgemäßen Untersuchungstechniken als auch Richtlinien gemäß der DC/TMD beinhalteten. Jede Station musste von den Studierenden innerhalb von sieben Minuten absolviert werden. Dabei umfasste Station A die Palpation der Kaumuskulatur, Station B die Messung der Kieferbeweglichkeit und Station C Untersuchungen des Kiefergelenkes. Sowohl die Interventionsgruppe als auch die Kontrollgruppe erhielten eine Woche vor Beginn der OSCE das deutsche DC/TMD-Manual sowie Fotos mit den entsprechenden Palpationsbereichen im Mund-, Kiefer- und Gesichtsbereich in Papierform ausgehändigt. Lediglich die Interventionsgruppe bekam das deutsche Instruktionsvideo einmalig eine Woche vor Beginn der OSCE zu sehen. Um die OSCE subjektiv zu beurteilen, wurden nach Beendigung des Testverfahrens die Studierenden gebeten einen Fragebogen auszufüllen. Der Bewertungsgrad wurde über eine 5-point Likert scale (trifft zu, trifft eher zu, teils-teils, trifft eher nicht zu, trifft nicht zu) erfasst. Die Studierenden gaben ihr Feedback zum erstellten Lehrvideo sowie zu der Frage, ob ein solches Lehrvideo fester Bestandteil der zahnmedizinischen Ausbildung sein sollte. In der Auswertung konnte gezeigt werden, dass die Gesamtsummen und die Summenwerte jeder einzelnen OSCE-Station in der Interventionsgruppe höher ausfielen als in der Kontrollgruppe. Hier zeigte sich jedoch keine statistische Signifikanz (p ≥ 0.189). Aufgrund der vorliegenden Daten konnte die Hypothese, dass es keine signifikanten Unterschiede in den OSCE-Ergebnissen der Studierenden gibt, die das Manual gelesen und das Instruktionsvideo gesehen haben und denen, welchen lediglich das Manual zur Vorbereitung auf die Untersuchung zur Verfügung stand, eindeutig bestätigt werden. Die Messung der Kieferbeweglichkeit wurde von den Studierenden als schwierig empfunden. Insgesamt gaben 87.5 % der Studierenden der Interventionsgruppe an, dass ihnen das Ansehen des Lehrfilmes geholfen hat, die OSCE zu bestehen. 95.8 % der teilnehmenden Studierenden gaben positive Rückmeldungen für die Integration des Lehrvideos in die zahnmedizinische Ausbildung. Das deutsche Instruktionsvideo kann gleichermaßen für Studierende und für die postgraduale Ausbildung eine gewinnbringende Unterstützung darstellen. Die DC/TMD bieten die Möglichkeit national sowie international einen diagnostischen Standard in der Befunderhebung und Diagnosestellung kraniomandibulärer Dysfunktionen zu etablieren. Nur durch eine Verbesserung der Diagnosestellung, ist auch eine Verbesserung der Gesamtsituation erreichbar und es können sowohl Leiden der Patienten als auch Behandlungskosten für die Gesellschaft reduziert werden. Damit trägt die vorliegende Arbeit zur Unterstützung der Versorgungssituation im zahnmedizinischen Bereich bei.

The temporomandibular disorders (TMD) diminish quality of life and can be costly for both individuals and the health care system. Stress from a variety of factors, including daily hassles and maladaptive thought patterns, has been commonly cited as a contributing factor in TMD. Support for this hypothesis comes from research demonstrating masseter muscle hyperactivity in response to experimental stressors, such as painful or frustrating stimuli. Many believe the link between stress and increased masseter muscle pain is parafunctional oral habits, including teeth clenching, grinding, and lip biting. Habit reversal has been used effectively to treat parafunctional oral behaviors and facial pain. Treatment entails teaching individuals to detect, interrupt, and reverse maladaptive oral behaviors. Positive results have been achieved in a group treatment format. Problems with prior research suggest that high attrition resulted from scheduling demands of the group treatment format. To address these problems, this study modified the habit reversal protocol used by Gramling, et al. (1996, 1999) into a minimal contact therapy (MCT) format. MCT has been applied effectively with many problem behaviors, including chronic headaches. Twenty individuals (10-treatment and 10-waitlist control) participated in the seven-lesson, manualized treatment. Participants completed a pre- and post-treatment assessment and an 18-month follow-up. Individuals met with the therapist one time and received weekly feedback via telephone or e-mail. Participants submitted homework and quizzes for each lesson. Those in the control condition spoke with the therapist on a weekly basis as an attention control. Treatment lasted a mean of about 20 weeks. Significant improvement in pain severity including mean pain levels, highest weekly pain levels, and number of pain free days was noted in the treatment group relative to controls. The number and frequency of maladaptive oral habits revealed a strong trend towards lower levels from pre- to post-treatment for individuals in the treatment condition relative to controls. Additional measures of pain symptomotology and personality functioning also revealed significant improvements in the treatment group. Results suggest that a standardized treatment for facial pain is well suited for adaptation to a MCT format. Minimal contact therapy is flexible and as effective as similar group treatments.

Two-dimensional (2D) materials have attracted extensive research interest in recent years. Among them, graphene and the semiconducting transition metal dichalcogenides (TMDs) are considered as promising candidates for future device applications due to their unique atomic thickness and outstanding properties. The study on graphene and TMDs has demonstrated great potential to further push the scaling of devices into the sub-10 nanometer regime and enable endless opportunities of novel device architectures for the next generation. In this thesis, crucial challenges facing 2D materials are investigated from material synthesis to electronic applications. A comprehensive review of the direct synthesis of graphene on arbitrary substrates with an emphasis on the metal-catalyst-free synthesis is given, followed by a detailed study of the contact engineering in TMDs with a focus on the strategies to lower the contact resistance. Effective approaches have been demonstrated to solve these issues. These include: (1) metal-catalyst-free synthesis of graphene on various insulating substrates; (2) Fermi level pinning observed in TMDs and integration of graphene contact to lower the contact resistance; and (3) application of metal-insulator-semiconductor (MIS) contact in TMD field-effect transistors (FETs). First, a direct low-temperature synthesis of graphene on insulators without any metal catalysts has been realized. The effects of carbon sources, NH3/H2 concentrations, and insulating substrates on the material synthesis have been systematically investigated. Graphene transistors based on the as-grown material have been fabricated to study the electronic properties, which can further confirm the nitrogen-doped graphene has been synthesized from the electrical characterizations. Then electronic devices focusing on the semiconducting TMDs has been studied. The Fermi level pinning has been observed and studied in WS2 FETs with four metal materials. A novel method of using graphene as an insertion layer between the metal and TMDs has been proven to effectively reduce the contact resistance. Owing to the benefit of tuning the graphene work function via the electric field, the contact resistance can further be reduced. Finally, the effectiveness of MIS contacts in WS2 FETs has been demonstrated. A thickness dependence research has been conducted to find the optimal thickness of the inserted insulator. Moreover, the possible physical mechanism of how this MIS contact reduces the contact resistance in 2D materials has been discussed.

O estresse emocional é um fenômeno de alta incidência na sociedade globalizada que tem sido relacionado como possível fator etiológico de muitas doenças. O efeito da atividade adrenérgica no aumento do tono dos músculos esqueléticos durante os episódios de estresse crônico sugere a ocorrência de outras alterações estruturais e funcionais do sistema estomatognático, mas o mecanismo pelo qual os fatores emocionais podem causar disfunção muscular não está bem esclarecido. A maloclusão por perda dental também promove alterações musculares que associadas com os efeitos do estresse podem ter grande impacto na etiologia e desenvolvimento da dor e disfunção orofacial. Estresse e hipofunção mastigatória são fatores relacionados com a aparição das desordens temporomandibulares (DTM) e não têm sido avaliados no músculo pterigóideo medial. O objetivo deste trabalho foi investigar os efeitos do estresse agudo e crônico em músculo pterigóideo medial, de animais submetidos ou não à exodontia unilateral, por meio de análises morfológicas e fisiológicas. Quarenta ratos machos Wistar (&#9794;-200g), adultos jovens, foram divididos aleatoriamente em dois grupos: Grupo Maloclusão (M=20): induzida pela exodontia unilateral dos molares superiores esquerdos e Grupo Sem Maloclusão (S=20): ratos sem exodontia. Cada grupo (n=20) foi subdividido em quatro subgrupos (n=5): controle (GC); estresse agudo (GA); estresse crônico repetido (GR) e estresse crônico variado (GV). Os protocolos de estresse foram realizados a partir do 14º dia após a exodontia. Estresse por restrição física foi usado no GA (2 horas, 23º dia) e no GR (14º a 23º dia); cinco metodologias diferentes foram submetidas ao GV (14º a 23º dia). Eutanásia e coleta de amostras foram realizadas no 23º dia. Foram avaliados os seguintes parâmetros: Corticosterona plasmática, peso, morfologia celular por meio de Hematoxilina eosina (HE), atividade metabólica e capacidade oxidativa do músculo por histoquímica para succinato deshidrogenase (SDH) e nicotinamida adenina dinucleotídeo (NADH), produção de espécies reativas de oxigênio (ROS) e densidade capilar por imunoistoquímica para as proteínas alfa CD-31 e laminina. Observada a normalidade dos dados, foi realizado o teste ANOVA fatorial, com fatores de variação fixos seguida pelo teste de Tukey-Kramer (p<0,05). O estresse e a maloclusão isolados ou associados produziram alterações morfológicas e fisiológicas no músculo pterigóideo medial ipsilateral à exodontia; dismorfismo das fibras musculares e núcleos de localização central foram induzidos por ambos os fatores; aumento do metabolismo oxidativo foi observado com o estresse e o efeito antagônico com a maloclusão; o estresse aumentou a densidade capilar do músculo e uma tendência ao maior estresse oxidativo foi observada. A associação de estresse crônico e maloclusão aumentaram o metabolismo glicolítico. Conclui-se que o estresse sistêmico crônico tem efeitos morfológicos e fisiológicos no músculo pterigóideo medial e quando associado à hipofunção mastigatória pode ser fator na etiopatogenia das DTM. / Emotional stress is a phenomenon of high incidence at globalized society that has been linked as a possible etiologic factor for many diseases. The effect of adrenergic activity in increased tone of skeletal muscles during episodes of chronic stress suggests the occurrence of others structurals and functionals alterations in the stomatognathic system, but the mechanism by which emotional factors can cause muscle dysfunction is not well understood. The malocclusion by tooth loss also promotes muscle changes that associated with the effects of stress can have a big impact on the etiology and development of orofacial pain and dysfunction. Stress and masticatory hypofunction are factors related to the appearance of temporomandibular disorders (TMD) and have not been evaluated in the medial pterygoid muscle. The aim of this work was to investigate the effects of acute and chronic stress on the medial pterygoid muscle of animals subjected or not to unilateral extraction, through morphological and physiological analyse. Forty male Wistar rats (&#9794;-200g), young adults were randomly divided into two groups: Malocclusion group (M = 20) induced by unilateral upper left molar extraction and Not Malocclusion Group No (S = 20): rats without extractions. Each group (n = 20) was subdivided into four subgroups (n = 5): control group (CG), acute stress (GA), repeated chronic stress (GR) and varied chronic stress (GV). Stress protocols were performed from 14th day after the extraction. Stress by physical restriction was used in GA (two hours, day 23th) and GR (day 14th to 23th); GV was subjected to five different methodologies (day 14th to 23th). Euthanasia and collection of samples were performed on day 23th. It was evaluated: cell morphology by hematoxylin eosin (HE), metabolic activity and muscle oxidative capacity by staining for succinate dehydrogenase (SDH) and nicotinamide adenine dinucleotide (NADH), production of reactive oxygen species (ROS) and capillary density of muscle by immunohistochemistry for proteins alpha CD-31 and Laminin. Normal distribution of data was observed. A factorial ANOVA test with fixed factors of variation was performed and then Tukey-Kramer test (p <0,05). Stress and malocclusion, isolated or associated, induced morphological and physiological changes in the left medial pterygoid muscle; dimorphism of muscle fibers and nuclei of central localization were induced by both factors; increased oxidative metabolism was observed with stress and antagonistic effect with malocclusion; stress increased muscle capillary density and a tendency to oxidative stress increased was observed. The association of chronic stress and malocclusion had increased the glycolytic metabolism. It was concluded that systemic chronic stress has physiological and morphological effects in the medial pterygoid muscle and associated with masticatory hypofunction, could be a possible cause for the development of TMD.

p. 1-100 / Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2013-04-24T19:12:25Z No. of bitstreams: 1 44444444.pdf: 487207 bytes, checksum: d514f9fc998cfa69a74ffdae60da439f (MD5) / Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-05-04T17:26:07Z (GMT) No. of bitstreams: 1 44444444.pdf: 487207 bytes, checksum: d514f9fc998cfa69a74ffdae60da439f (MD5) / Made available in DSpace on 2013-05-04T17:26:07Z (GMT). No. of bitstreams: 1 44444444.pdf: 487207 bytes, checksum: d514f9fc998cfa69a74ffdae60da439f (MD5) Previous issue date: 2008 / Introdução: A disfunção temporomandibular (DTM) caracteriza-se por dor na musculatura mastigatória, na articulaçãotemporomandibular, estalidos e limitação funcional. Tem como fatores etiológicos o estresse e a sobrecarga articular, condições presentes no teleatendimento. Embora o potencial patogênico nesta atividade seja um problema de saúde pública, a investigação acerca da DTM nesta população ainda é incipiente. Objetivo: descrever a frequência de disfunção temporomandibular entre teleatendentes e identificar fatores associados a sua ocorrência, focalizando, em especial, aqueles relacionados à ocupação. Métodos: Conduziu-se um estudo de corte transversal, exploratório, envolvendo 200 teleatendentes de um call center, mediante realização de entrevista e exame físico. Foram considerados aspectos clínicos, sócio demográficos, ocupacionais, psicossociais da ocupação (JCQ) e estresse psíquico (SQG12). Estabeleceram-se os sinais e sintomas, e a gravidade da DTM através da escala RDC/TMD e TMI respectivamente. Procedeu-se a análise descritiva e odds ratio (OR) foram estimados por meio de regressão logística não-condicional, empregando-se o IC a 95% como critério para aceitar as associações. Resultados: A frequência de DTM entre os teleatendentes foi 40,50%, com baixa gravidade (TMI=0,08±0,02). Observou-se uma associação positiva entre tempo de atividade (ORajust= 2,0; 95%IC: 1,1- 4,0), número médio de ligações por dia (ORajust=2,1; 95%IC: 1,1- 3,9) e nível de estresse (ORajust= 2,1; 95%IC: 1,1- 4,4) e a DTM. Considerações finais: Sugere-se, na população estudada, uma associação entre tempo de atividade maior do que 7 meses, número médio acima de 82 ligações por dia, alto nível de estresse e DTM. O conhecimento dos fatores ocupacionais associados à DTM nesta população favorece o estabelecimento de ações preventivas ou interceptativas, com vistas a diminuir a prevalência. Indica ainda a necessidade de atenção a esta atividade que está relacionada a múltiplos efeitos. / Salvador

Made available in DSpace on 2014-06-11T19:28:34Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-12-12Bitstream added on 2014-06-13T18:57:54Z : No. of bitstreams: 1 silva_aml_me_guara.pdf: 1372198 bytes, checksum: 8bdab5df0828cfa6c6b83983a359c40b (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O presente trabalho tem por objetivos, analisar a intensidade e freqüência dos ruídos articulares da articulação temporomandibular (A.T.M.) de indivíduos saudáveis e patológicos, auxiliar nos procedimentos clínicos e em futuras pesquisas. Para a análise dos sinais coletados foi desenvolvido um sistema para aquisição de dados, composto por um conjunto estetoscópio/microfone, equipamentos para condicionamento e aquisição de sinais e aplicativos computacionais para registro, análise e apresentação dos dados. A identificação das freqüências dominantes e o cálculo dos parâmetros considerados no domínio do tempo (valor médio, valor eficaz, desvio padrão e nível da pressão sonora – NPS) foram realizados por meio de programas computacionais específicos. Os resultados decorrentes dos cálculos e das observações em relação aos sinais obtidos, possibilitaram a determinação das faixas de freqüência, o nível da pressão sonora em decibéis (dB)* da população em estudo, além de proporcionar algumas diferenças entre os grupos patológicos e não-patológicos. Pode-se concluir que a presença da patologia influiu na amplitude dos sinais coletados, diferenciando dessa forma os casos patológicos dos não patológicos. Outra contribuição desse trabalho foi o desenvolvimento de um exame não invasivo para as Disfunções das Articulações Temporomandibulares (D.T.Ms.) / This word has the objective of analyzing the amount and frequency of articular noise in temporomandibular joint (TMJ) of both healthy and pathological individuals and aid in clinical procedures as well as in future researches. For the proposed analysis, a dada collecting system was developed comprising a stethoscope/microphone set, equipment for the signal conditioning and capturing, and computer software for data recording, analysis and presentation. The identification of dominating frequencies and the parameter calculation considered in the time period (average amount, efficient amount, linear fit, and sound pressure level) were performed through specific computer softwares. The results found through the calculations and observations in relation to the signals obtained made the determination of the frequency, the level of sound pressure (in dB) of the studied population possible besides differentiating the pathological and non-pathological groups. It can be concluded that the presence of the pathology influenced in the amplitude of the collected signals, differentiating of this form the pathological cases of the not pathological ones. Another contribution of this work was the development of a not invasive examination for the temporomandibular dysfunction (TMD)

O estresse emocional é um fenômeno de alta incidência na sociedade globalizada que tem sido relacionado como possível fator etiológico de muitas doenças. O efeito da atividade adrenérgica no aumento do tono dos músculos esqueléticos durante os episódios de estresse crônico sugere a ocorrência de outras alterações estruturais e funcionais do sistema estomatognático, mas o mecanismo pelo qual os fatores emocionais podem causar disfunção muscular não está bem esclarecido. A maloclusão por perda dental também promove alterações musculares que associadas com os efeitos do estresse podem ter grande impacto na etiologia e desenvolvimento da dor e disfunção orofacial. Estresse e hipofunção mastigatória são fatores relacionados com a aparição das desordens temporomandibulares (DTM) e não têm sido avaliados no músculo pterigóideo medial. O objetivo deste trabalho foi investigar os efeitos do estresse agudo e crônico em músculo pterigóideo medial, de animais submetidos ou não à exodontia unilateral, por meio de análises morfológicas e fisiológicas. Quarenta ratos machos Wistar (&#9794;-200g), adultos jovens, foram divididos aleatoriamente em dois grupos: Grupo Maloclusão (M=20): induzida pela exodontia unilateral dos molares superiores esquerdos e Grupo Sem Maloclusão (S=20): ratos sem exodontia. Cada grupo (n=20) foi subdividido em quatro subgrupos (n=5): controle (GC); estresse agudo (GA); estresse crônico repetido (GR) e estresse crônico variado (GV). Os protocolos de estresse foram realizados a partir do 14º dia após a exodontia. Estresse por restrição física foi usado no GA (2 horas, 23º dia) e no GR (14º a 23º dia); cinco metodologias diferentes foram submetidas ao GV (14º a 23º dia). Eutanásia e coleta de amostras foram realizadas no 23º dia. Foram avaliados os seguintes parâmetros: Corticosterona plasmática, peso, morfologia celular por meio de Hematoxilina eosina (HE), atividade metabólica e capacidade oxidativa do músculo por histoquímica para succinato deshidrogenase (SDH) e nicotinamida adenina dinucleotídeo (NADH), produção de espécies reativas de oxigênio (ROS) e densidade capilar por imunoistoquímica para as proteínas alfa CD-31 e laminina. Observada a normalidade dos dados, foi realizado o teste ANOVA fatorial, com fatores de variação fixos seguida pelo teste de Tukey-Kramer (p<0,05). O estresse e a maloclusão isolados ou associados produziram alterações morfológicas e fisiológicas no músculo pterigóideo medial ipsilateral à exodontia; dismorfismo das fibras musculares e núcleos de localização central foram induzidos por ambos os fatores; aumento do metabolismo oxidativo foi observado com o estresse e o efeito antagônico com a maloclusão; o estresse aumentou a densidade capilar do músculo e uma tendência ao maior estresse oxidativo foi observada. A associação de estresse crônico e maloclusão aumentaram o metabolismo glicolítico. Conclui-se que o estresse sistêmico crônico tem efeitos morfológicos e fisiológicos no músculo pterigóideo medial e quando associado à hipofunção mastigatória pode ser fator na etiopatogenia das DTM. / Emotional stress is a phenomenon of high incidence at globalized society that has been linked as a possible etiologic factor for many diseases. The effect of adrenergic activity in increased tone of skeletal muscles during episodes of chronic stress suggests the occurrence of others structurals and functionals alterations in the stomatognathic system, but the mechanism by which emotional factors can cause muscle dysfunction is not well understood. The malocclusion by tooth loss also promotes muscle changes that associated with the effects of stress can have a big impact on the etiology and development of orofacial pain and dysfunction. Stress and masticatory hypofunction are factors related to the appearance of temporomandibular disorders (TMD) and have not been evaluated in the medial pterygoid muscle. The aim of this work was to investigate the effects of acute and chronic stress on the medial pterygoid muscle of animals subjected or not to unilateral extraction, through morphological and physiological analyse. Forty male Wistar rats (&#9794;-200g), young adults were randomly divided into two groups: Malocclusion group (M = 20) induced by unilateral upper left molar extraction and Not Malocclusion Group No (S = 20): rats without extractions. Each group (n = 20) was subdivided into four subgroups (n = 5): control group (CG), acute stress (GA), repeated chronic stress (GR) and varied chronic stress (GV). Stress protocols were performed from 14th day after the extraction. Stress by physical restriction was used in GA (two hours, day 23th) and GR (day 14th to 23th); GV was subjected to five different methodologies (day 14th to 23th). Euthanasia and collection of samples were performed on day 23th. It was evaluated: cell morphology by hematoxylin eosin (HE), metabolic activity and muscle oxidative capacity by staining for succinate dehydrogenase (SDH) and nicotinamide adenine dinucleotide (NADH), production of reactive oxygen species (ROS) and capillary density of muscle by immunohistochemistry for proteins alpha CD-31 and Laminin. Normal distribution of data was observed. A factorial ANOVA test with fixed factors of variation was performed and then Tukey-Kramer test (p <0,05). Stress and malocclusion, isolated or associated, induced morphological and physiological changes in the left medial pterygoid muscle; dimorphism of muscle fibers and nuclei of central localization were induced by both factors; increased oxidative metabolism was observed with stress and antagonistic effect with malocclusion; stress increased muscle capillary density and a tendency to oxidative stress increased was observed. The association of chronic stress and malocclusion had increased the glycolytic metabolism. It was concluded that systemic chronic stress has physiological and morphological effects in the medial pterygoid muscle and associated with masticatory hypofunction, could be a possible cause for the development of TMD.

A complete, fundamental understanding of the proton must include knowledge of the underlying spin structure. The transversity distribution, h1(x), which describes the transverse spin structure of quarks inside of a transversely polarized proton, is only accessible through channels that couple h1(x) to another chiral odd distribution, such as the Collins fragmentation function (ΔN Dπ/q↑(z,jT)). Significant Collins asymmetries of charged pions have been observed in semi-inclusive deep inelastic scattering (SIDIS) data. These SIDIS asymmetries combined with e+e- process asymmetries have allowed for the extraction of h1(x) and ΔN Dπ/q↑(z,jT). However, the current uncertainties on h1(x) are large compared to the corresponding quark momentum and helicity distributions and reflect the limited statistics and kinematic reach of the available data. In transversely polarized hadronic collisions, Collins asymmetries may be isolated and extracted by measuring the spin dependent azimuthal distributions of charged pions in jets. This thesis will report on the first statistically significant Collins asymmetries extracted from √ s = 200 GeV hadronic collisions using 14 pb-1 of transversely polarized proton collisions at 57% average polarization.