As atividades eletromiográficas dos músculos masseter e temporal anterior foram avaliadas em amostra constituída por 37 indivíduos assintomáticos, com maloclusão de Classe I divididos em dois grupos - Experimental e Controle. O grupo Experimental foi composto por 23 indivíduos, sendo 14 do gênero masculino e 9, do feminino, com média de idade de 23 anos e 7 meses, e foi submetido à desprogramação neuromuscular, com o uso de placa oclusal, pelo período médio de 6 meses e 3 dias. O grupo Controle foi formado por 14 indivíduos, sendo 11 do gênero feminino e 3, do masculino, com média de idade de 25 anos e 11 meses, e não fez uso de placa oclusal, nem foi submetido a qualquer intervenção oclusal, no período médio de observação de 8 meses e 10 dias. Os registros eletromiográficos foram realizados por meio de eletrodos bipolares de superfície durante o repouso mandibular e o apertamento oclusal máximo, em dois momentos - T1 e T2. Os valores obtidos foram mensurados pelo cálculo do \"Root Mean Square\" (RMS) e expressos em microvolts (μV). Os índices de assimetria e atividade foram calculados em porcentagem (%). Os dados foram analisados estatisticamente por meio dos testes ANOVA e Bonferroni, considerando-se o nível de significância de 5%. Os resultados mostraram que no grupo Experimental, após o uso da placa oclusal, ocorreu redução significante das atividades eletromiográficas de repouso, assim como aumento significante da atividade eletromiográfica em apertamento oclusal máximo. O grupo controle não mostrou qualquer diferença estatisticamente significante entre os momentos. Os índices de assimetria mostraram que, no repouso mandibular, os músculos do lado esquerdo foram mais ativos. Os índices de atividade mostraram que o músculo temporal anterior apresenta maior contribuição relativa, quando comparado ao masseter, no repouso mandibular. Ambos os índices não sofreram alterações significantes entre os momentos estudados, nos dois grupos. / The electromyographic activity of the muscles masseter and temporal (anterior part) was evaluated in a sample of 37 asymptomatic subjects with Class II malocclusion. They were divided in two groups - experimental and control. The experimental group consisted of 23 subjects, 14 males and 9 females, mean age 23y 7m. This group was neuromuscularly deprogrammed with the use of occlusal splints during a mean period of 6 months and 3 days. The control group was formed by 14 individuals, 3 males and 11 females, mean age 25y 11m. This group did not wear occlusal splint nor suffered any occlusal intervention for a mean observation period of 8 months and 10 days. The electromyographic recordings were accomplished by means of surface bipolar electrodes. The recordings were taken at two different moments - T1 and T2, at mandibular rest position and maximal occlusal clenching. The obtained values were measured by the calculating \"Root Mean Square\" (RMS) and they were expressed in microvolts (цV). The asymmetry and activity indexes were calculated in percentage (%). The data was statistically evaluated by ANOVA and Bonferroni`s tests, considering the level of significance of 5%. The results showed that in the group that wore the occlusal splint occurred a significant reduction of the eletromyographics activities at rest position, as well as a significant increase of the electromyographics activities at maximal occlusal clenching. The control group did not show any significant change in the observated period. The asymmetry indexes showed at mandibular rest, that the left side muscles were more actives. The activity indexes also showed that the temporal muscle presents a relative greater contribution for the maintenance of the rest mandibular position. The indexes - asymmetry and activity - did not present significant changes between the moments for both groups.

Magister Scientiae Dentium - MSc(Dent) / It is generally agreed that the most troublesome procedure during the fabrication of complete dentures is the measurement of the Vertical Dimension at rest. The aim of this study was to test the reliability and validity of a new instrument called the Facial Anthropological Device (FAD). The measurements recorded were compared to the Willis gauge (being the gold standard) and dividers, which are mechanical aids used to quantify lower third facial height during denture construction. This thesis presents data on 35 edentulous and 35 dentate patients in the age range of 30 to 70 years, who presented at the University of the Western Cape Dental faculty.The FAD incorporates a ‘spirit‐level’ and uses more anatomical landmarks than any other measuring device noted in the literature. It measures facial landmarks in the midline and is not only used to measure the vertical dimension of the face, but with further research, may also be used in forensic studies. The Willis gauge is designed to measure the distance from the lower border of the septum of the nose to the lower border of the chin, and the distance from the outer canthus of the eye to the corner of the relaxed lip with the teeth in occlusion. The dividers measures two arbitrary points on the face.The study showed that the FAD was most similar to the Willis gauge where reliability and reproducibility was compared. There were no statistically significant differences (P > 0.05) between the two devices.The FAD has shown to be a reliable and valid instrument that could be used to measure facial vertical dimension in the edentulous as well as dentate patients, however with some modifications to its design.

La courbe de Spee est une courbe située dans un plan para-sagittal. Son étude se fait uniquement au niveau des dents mandibulaires. Il ne s’agit pas d’un « simple » plan d’occlusion dentaire puisque cette courbe intéresse, également de l’os, c’est à dire le condyle mandibulaire et plus particulièrement son bord antérieur. La courbe de Spee est dépendante de l’emplacement du condyle mais également de l’axe de chacune des dents mandibulaires qui participent à sa forme. Son incurvation permet d’aligner les directions des contraintes le long des grands axes dentaires. À partir des valeurs métriques et angulaires mesurées sur des images 3D de mandibules numérisées les objectifs ont été : - de proposer une aide dans la reconstruction de mandibule incomplète et/ou déformée et du plan occlusal absent ou incomplet. - de dégager des principes géométriques simples permettant une optimisation du positionnement des racines artificielles (implants) chez l’Homme actuel. Ainsi les études des axes dentaires mandibulaires, de la position du condyle mandibulaire, de la courbe de Spee, ou encore de différentes mesures mandibulaires, ont permis de dégager un axe de recherche anthropologique et un axe de recherche odontologique Un axe anthropologique Qui amène à la découverte validée de formules de régressions pouvant apporter une aide dans la reconstructions de matériel dentaire, ou osseux incomplet, mandibulaire. Un axe odontologique Qui confirme, et valide cliniquement, que les axes dentaires mandibulaires doivent être orientés le plus favorablement possible en fonction des diverses contraintes occlusales. / The curve of Spee is situated in a para-sagittal plane. His study is done only at the mandibular teeth. It is not a "simple" plan of dental occlusion because this curve interests, also of bone, the mandibular condyle and particularly its front edge. The curve of Spee depends on the condyle location but also on the axis of each of the mandibular teeth which participate in its shape. Its curve aligns the directions of the constraints along major dental axes. From metrics and angular values measured on 3D images of scanned mandibles, the objectives were: - To propose a help in the reconstruction of incomplete and / or deformed mandible and absent or incomplete occlusal plane. - To identify simple geometric principles to optimize the positioning of the artificial roots (implants) in modern Man. So the studies of mandibular dental axes, the position of the mandibular condyle, the curve of Spee, or differents mandibular measures allowed to clear an area of anthropological research and an area of Dental Research An anthropological area Which leads to the validated discovery regression formulas, which can brings help in reconstruction of dental material, or osseous incomplete, mandibular. An odontological area Which confirms and validates clinically, that the mandibular dental axes must be oriented as favorably as possible according to the various occlusal constraints.

Hipótese do trabalho: Avaliar a presença de um orifício de acesso ao parafuso do intermediário do implante em infra-estruturas cimentadas sobre o pilar de titânio. Objetivo: O presente estudo visou comparar resistência a compressão de infra-estruturas em zircônia estabilizada por ítrio e em dissilicato de lítio cimentadas sobre pilar em titânio, com e sem acesso ao parafuso. Método: Foram confeccionados quarenta corpos-de-prova compostos por análogos de implantes hexágono externo de plataforma 4,1mm, intermediários de titânio pré-fabricado para próteses cimentadas e infra-estruturas para coroas totais. Os corpos-de-prova foram divididos em quatro grupos experimentais, sendo vinte, em cerâmica de zircônia estabilizada por ítrio(G1 e G2) e vinte em cerâmica de dissilicato de lítio(G3 e G4), todas confeccionadas com a mesma anatomia, ambas para próteses cimentadas sobre implante. Das vinte infra-estruturas de cada tipo de cerâmica, dez foram infra-estruturas convencionais para coroas cimentadas, constituindo o grupo controle e dez apresentavam um orifício de acesso ao parafuso, transpassando a cerâmica, constituindo o grupo experimental. As cimentações foram efetuadas com agente de fixação RelyX U200, de acordo com as especificações do fabricante, e o grupo experimental (com acesso ao parafuso) teve o orifício de acesso ao canal restaurado com resina composta foto ativada Z350 Filtek Supreme XT. Os corpos-de-prova foram submetidos a teste de compressão com velocidade de 0,5mm/minuto em máquina de ensaio universal. Resultados: Não foram encontradas diferenças estatísticas significativas entre infra-estruturas de cerâmicas convencionais e as infra-estruturas confeccionadas com orifício de acesso oclusal(G2 1.675 N/cm., G3 1.931 N/cm e G4 1.447 N/cm), exceto as infra-estruturas convencionais de zircônia estabilizada por ítrio que se apresentou superior aos demais(G1 3.372 N/cm). Com base nos resultados todas as modalidades de infra-estruturas testadas são viáveis para o uso clínico. / Hypothesis of work: To evaluate the presence of an access hole to screw the intermediate cemented implant in infrastructure over the titanium abutment. Objective: This study aimed to compare the compressive strength of infrastructure in yttrium stabilized zirconia and lithium disilicate cemented to abutment in titanium, with and without access to the screw. Method: Forty bodies-specimens consisting of similar external hex implants platform 4.1mm, intermediate titanium prefabricated for cemented prostheses and infrastructures for crowns were fabricated. The bodies-specimens were divided into four experimental groups, twenty, ceramic yttrium stabilized zirconia (G1 and G2) and twenty in ceramic lithium disilicate (G3 and G4), all made with the same anatomy, both for cemented prostheses on implants. Infrastructure of twenty of each type of tile ten were conventional infrastructure for cemented crowns, constituting the control group and ten had an access hole to the screw, trespassing ceramics, constituting the experimental group. The cementation were performed with RelyX U200 fixing agent, according to the manufacturers specifications, and the experimental group (with access to the screw) had the access hole channel restored with composite resin Z350 photo activated Filtek Supreme XT. The bodies-specimens were subjected to compression test speed of 0.5 mm / min in a universal testing machine. Results: No statistically significant differences between conventional ceramic infrastructure and infrastructure made with port access were found occlusal (G2 1675 N / cm, G3 1931 N / cm and G4 1447 N / cm.) Except conventional infrastructure stabilized zirconia yttrium who introduced himself superior to the others (G1 3300 N / cm). Based on the results of all modalities tested infrastructure are feasible for clinical use.

Esta pesquisa avaliou o sistema estomatognático de crianças saudáveis com ou sem necessidade de tratamento ortodôntico por meio do desempenho mastigatório, contato de forças oclusais e mobilidade mandibular. Noventa crianças foram selecionadas e distribuídas em três grupos: GSN (Grau 1, sem necessidade de tratamento ortodôntico, 8,00 ± 0,43 anos de idade, n = 26), GPN (Grau 2, pequena necessidade de tratamento, 8,89 ± 0,43 anos de idade, n = 28) e GMN (Grau 3, moderada necessidade de tratamento ortodôntico, 8,44 ± 0,22 anos de idade, n = 36). A necessidade de tratamento ortodôntico foi classificada pelo Índice de Necessidade de Tratamento Ortodôntico - Componentes de Saúde Dental (IOTN-DHC). O desempenho mastigatório foi avaliado pelo integral da envoltória do sinal eletromiográfico durante os ciclos mastigatórios do músculo masseter, temporal, orbicular da boca (segmento direito e segmento esquerdo) e supra-hioideo na mastigação habitual com alimentos macios e consistentes. Foi utilizado o sistema Trigno EMG com eletrodos sem fio para captação e análise do sinal eletromiográfico (µV). O sistema T-Scan® III Occlusal Analysis foi utilizado para analisar o contato de forças oclusais (%) entre as hemiarcadas superior e inferior (lado direito e esquerdo). A amplitude (mm) de abertura normal e abertura máxima voluntária e movimentos bordejantes mandibulares (lateralidade direita, lateralidade esquerda e protrusão) foi mensurada com régua milimetrada. Os dados obtidos foram tabulados e submetidos à análise estatística (SPSS 22.0, ANOVA, teste post-hoc de Bonferroni, p ≤0,05). Verificou-se que GMN apresentou menor desempenho mastigatório e desequilíbrio de forças oclusais na maxila/mandíbula em relação GPN e GSN, sem diferença significativa, e maior amplitude de abertura da boca e movimentos excursivos mandibulares com diferença significativa na abertura normal (p=0,02). Portanto, crianças com moderada necessidade de tratamento ortodôntico apresentaram alterações funcionais no sistema estomatognático, em especial no desempenho mastigatório, força oclusal e mobilidade mandibular. / This research evaluated the stomatognathic system of healthy children with or without orthodontic treatment need through masticatory performance, occlusal strength and mandibular mobility. Ninety children were selected and distributed into three groups: GSN (Grade 1, no orthodontic treatment need, 8.00 ± 0.43 years old, n = 26), GPN (Grade 2, small orthodontic treatment need, 8.89 ± 0.43 years old, n = 28) and GMN (Grade 3, moderate orthodontic treatment need, 8.44 ± 0.22 years old, n = 36). The orthodontic treatment need was classified by the Orthodontic Treatment Need - Dental Health Components Index (IOTN-DHC). The masticatory performance was evaluated by the full linear envelope of the electromyographic signal during the masticatory cycles of masseter, temporal, mouth orbicularis (left and right segments) and suprahyoids muscles in the habitual chewing with soft and consistent foods. The Trigno EMG system was used with wireless electrodes to capture and analyze the electromyographic signal (µV). The T-Scan® III Occlusal Analysis system was used to analyze occlusal forces (%) between the upper and lower dental arch (right and left sides). The normal and maximum opening width (mm) and mandibular movements (right laterality, left laterality and protrusion) were measured with a millimeter ruler. Data were tabulated and submitted to statistical analysis (SPSS 22.0, ANOVA, Bonferroni post-hoc test, p≤0.05). It was verified that GMN presented lower masticatory performance and imbalance of the occlusal forces in maxila/ mandible to GPN and GSN, with no significant difference, and greater mouth opening amplitude and mandibular excursive movements, with significant difference, in normal opening mouth (p=0.02). Therefore, children with moderate orthodontic treatment need presented functional alterations in the stomatognathic system, especially in the masticatory performance, occlusal force and mandibular mobility.

Background: Maximal voluntary occlusal bite force (MVOBF) is the maximal force applied by the jaw muscles in dental occlusion. MVOBF is one parameter for functional capacity of the jaw system.  Aim: To evaluate MVOBF in different positions in the bite and to evaluate possible intra-individual differences between sessions.  Methods: MVOBF was measured with an electronic bite force device, with transducers sensitive to force, in 20 healthy men (mean 24.5 years). Eligibility of participants was full dental occlusion, Angle Class I relation, no diagnosis according to Diagnostic criteria for temporomandibular disorders. The test included three repeated measurements on each site: first molar right, first molar left and central incisor, in random order, with test-retest study design. Unpaired T-test was used to test the MVOBF in different positions in the bite and paired T-test for possible intra-individual differences between sessions. A post hoc test for repeated measure one-way ANOVA was added.  Results: MVOBF in different positions in the bite was lower in the incisor area compared with the molar region (P<0.0001), but similar between right and left molar side (P=0.48 and P= 0.96, respectively). No intra-individual differences between sessions (molar right P= 0.40; molar left P= 0.81; incisor area P= 0.66). The intra-individual variability for repeated measurements showed variability for incisor area (P= 0.007), but not for molar right and left region (P=0.95 and P=0.49, respectively).  Conclusion: The results may provide reference values for MVOBF in young adult men, to be compared with men with pain or dysfunction in the jaw system.

While dental caries represents the major chronic disease of humans, visual and tactile inspection are the methods of choice in daily dental practice. Several optical technologies have been developed in recent years for the purpose of dental examination, including near-infrared light transillumination as a promising tool for the supplementation and partial replacement of radiography. In case of occlusal alterations, the incidence of surface discolorations impedes the visual assessment, whereas tactile inspection appears to yield little diagnostic information or might be detrimental. Optical coherence tomography (OCT) facilitates depth-resolved imaging with μm resolution, utilizing near-infrared light, and has already shown its potential for various dental applications. We have recently demonstrated that depolarization imaging utilizing the degree of polarization uniformity (DOPU) extends those abilities by the detection of early carious lesions, as it provides an unambiguous demineralization contrast. Here, we show that this approach also enables the assessment of occlusal enamel lesions in the presence of stains, and compare PS-OCT cross sections with polarized light microscopy (PLM) images of thin sections. For tooth samples with discoloration or demineralization, respectively, PS-OCT and PLM results are in good agreement.

The functioning of maxillofacial complex as a one unit is an important condition of fulfilling several functions connected with this area of human body. A maxillofacial region and other parts of the body are connected through occlusion, one of the basic characteristics of which is occlusal plane. According to the number of researchers, 3D orientation of occlusal plane, its shape and possible deformation can have an influence on other anatomic structures via a system of a complex neuromuscular reactions. This theory assumes that the adjustment of occlusal plane inclination causes redistribution and redirection of the chewing forces in the adjacent structures which will subsequently manifest itself in the adjustment of the tension of different muscles. Aim The aim of an experimental part of the research was to define the influence of occlusal plane inclination on the function of maxillofacial region with the focus of jaw joints and chewing muscles. The next goal was to determine the figures of sagittal and frontal inclination of occlusal plane which can be considered as physiological. Patients and Methods The research was based on the examination of 87 people of both genders, different age groups with a complete set of teeth and without chronic diseases. The participants were divided in two groups...

Introduction : Plusieurs effets secondaires sont associés au traitement de l’apnée obstructive du sommeil (AOS) par appareil d’avancement mandibulaire (AAM). Pour minimiser leur occurrence, plusieurs professionnels préconisent l’utilisation d’une attelle de repositionnement matinal (ARM) malgré le manque d’évidences valides soutenant cette approche. Objectifs : L’objectif principal de cette étude pilote randomisée contrôlée est d’évaluer l’utilisation d’une ARM comme moyen d’atténuer les effets secondaires à court terme associés au traitement par AAM. Méthode : 9 sujets souffrant d’AOS nécessitant un traitement par AAM ont été inclus et assignés aléatoirement au groupe témoin (n=5) et au groupe traitement (n=4). Tous les participants ont été traités avec un AAM fabriqué sur mesure et ajustable (SomnoDent Flex, SomnoMed, USA). Les sujets du groupe traitement ont également reçu une qu’ils devaient porter 1 heure le matin suivant le retrait de leur AAM. La participation comprenait 6 visites échelonnées sur une période approximative de 8 mois durant lesquelles plusieurs variables ont été évaluées, notamment les changements occlusaux, les effets secondaires et l’adhérence au traitement. Résultats : Des tendances de réduction des surplombs horizontaux et verticaux, de la distance intermolaire maxillaire et de la longueur d’arcade totale supérieure ont été observées uniquement au sein du groupe témoin (p=0,063). Six mois suivant la fin de la période de titration, les problèmes masticatoires étaient plus fréquemment rapportés dans le groupe témoin. 60% des sujets traités uniquement avec un AAM en rapportaient sur une base hebdomadaire comparativement à ceux recevant conjointement une ARM, où la survenue était rare, voire absente. Conclusion : Nos résultats suggèrent que l’ajout d’une ARM pourrait être bénéfique au traitement de l’AOS par AAM en réduisant la survenue de certains effets secondaires à court terme. D’autres études bien construites sont nécessaires pour confirmer nos observations. / Introduction: There are several side-effects associated with mandibular advancement devices (MAD) used to treat obstructive sleep apnea (OSA). Despite the lack of evidence supporting their use, some providers advocate the use of morning repositioning splints (MRS) to minimize these side effects. Objectives: The main objective of this randomized controlled pilot study is to evaluate MRS-use as a means of mitigating MAD-associated short-term side-effects. Methods: 9 subjects with OSA requiring MAD-use were included in this study and were randomized into a control group (n=5) and a treatment group (n=4). All participants were treated with a customized adjustable MAD (SomnoDent Flex, SomnoMed, USA). Subjects in the treatment group also received an MRS that was to be used every morning for 1 hour after removal of their MAD. Follow-up consisted of 6 appointments over approximately 8 months. During this time, variables including occlusal changes, side effects and treatment adherence were evaluated. Results: A tendency for overjet and overbite reduction as well as maxillary intermolar distance reduction and superior arch length shortening were observed in the control group only (P=0.063). Six months after completion of MAD titration, masticatory problems were more frequently reported by subjects in the control group. 60% of these subjects reported masticatory problems on a weekly basis whereas subjects in the treatment group never or rarely reported these issues. Conclusion: Our results suggest that MRS-use can minimize short-term side effects associated with MADs used to treat OSA. Additional, well-constructed, studies are needed to confirm these findings.

Currently, many developing countries are experiencing rising prevalences of caries associated with changes in lifestyle and living conditions. Objectives: To describe the hygiene, eating habits, and oral health status of Nepalese children. Materials and Methods: A stratifiedsample of 231 children 5–7, 11–13, and 15–16 years of age (53% boys, 47% girls) who attended public high schools in the rural area of the Lalitpur District, Nepal was selected. The study was a field study combining a clinical examination (plaque, gingivitis, calculus, and caries) and a questionnaire. The questions concerned sanitary conditions, health support, personal hygiene, tooth cleaning, and eating habits. Results: During the school day, half of the children ate nothing at all. General personal hygiene was associated with tooth-cleaning frequency.Four out of five children in the entire sample cleaned their teeth once/day or more, using their own toothbrush. The use of fluoride toothpaste was rare.More frequent tooth cleaning and lower plaque indices were seen among girls and older children. More plaque was found on the occlusal surfaces of erupting permanent molars than on fully occluded permanent molars. Most children had a low prevalence of manifest caries in the primary and the permanent dentitions. However, every fifth 5–7-yr-old had manifest caries in three or more primary teeth. The occlusal surfaces of molars accounted for almost all registered caries in both dentitions. Conclusion: Although the prevalence of manifest caries was low, the low level of preventive activities may cause an increase in the prevalence of caries, as in other developing countries. The presumed risk scenario needs to be met by comprehensive and systematic health promotion and preventive measures. / Sammanfattning: I många utvecklingsländer sker förändringar av livsstil och levnadsförhållanden med samtidig ökad förekomst av karies. Mål: Att beskriva hygien, matvanor och munhälsa hos nepalesiska barn. Material och Metod: Ett stratifierat urval av 231 barn, som i åldrarna 5-7, 11-13 och 15-16 år (53% pojkar, 47% flickor), elever i statliga grundskolor på landsbygden, Lalitpur distriktet Nepal, användes. Studien utformades som en fältstudie med klinisk undersökning (plack, gingivit, tandsten och karies) kombinerad med en enkätstudie. Frågorna rörde sanitära förhållanden, hälsostöd från hemmet, personlig hygien, tandrengörings- och matvanor. Resultat: Under skoldagen åt hälften av barnen ingenting alls. Allmän personlig hygien var associerad med tandrengörings frekvens. Av alla barn, som användande sin egen tandborste, borstade fyra av fem, en gång om dagen eller mer. Äldre barn och flickor rengjorde tänderna oftare och hade ett lägre plackindex. Mer plack fanns på erupterande molarers occlusalytor jämfört med molarer i full ocklusion. De flesta barnen hade en låg frekvens manifest karies i primära och permanenta bettet. Dock hade en femtedel av 5-7 åringarna tre eller fler manifesta kariesangrepp i primära bettet. Ocklusal karies på molarerna utgjorde nästan all registrerad karies i båda dentitionerna. Slutsats: Låg frekvens av manifest karies, men en låg grad av förebyggande aktiviteter, kan medföra en ökad kariesfrekvens liknande den i andra utvecklingsländer. Den förmodande risken måste bemötas med behovsinriktade och systematiska hälsobefrämjande och preventiva åtgärder. / <p>ISBN 91-7997-151-2</p>