Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-06-18T21:35:52Z No. of bitstreams: 1 Bruno Roberto Borges Barbosa.pdf: 2216860 bytes, checksum: 0f76840e9c877a9697af40f1a2580480 (MD5) / Made available in DSpace on 2018-06-18T21:35:52Z (GMT). No. of bitstreams: 1 Bruno Roberto Borges Barbosa.pdf: 2216860 bytes, checksum: 0f76840e9c877a9697af40f1a2580480 (MD5) Previous issue date: 2015-12-04 / Introduction: Temporomandibular joint (TMJ) is part of the stomatognathic system (SE) and is responsible for sucking, chewing, talking, swallowing. The kinematics is a reliable tool for quantitative evaluation of the movement, which records the trajectories of markers fixed in the body segments and assesses more accurately the human movement. Objective: To a systematic review of the use of kinematics and its application in the TMJ and analyze the kinematic reproducibility of the jaw by means of a three-dimensional tool for functional activity. Material and Methods: The following databases were consulted: BIREME, Capes, PubMed, Science Direct, Scielo and Peter. The search terms used were: "Kinematics", "Temporomandibular Joint", "CentricRelation", "Movements", "Patient-SpecificModeling", "MovementDisorders" in English and Portuguese. After two reviewers independently search, 40 articles were found and after the application of the exclusion criteria, 17 articles were selected for analysis. Participants included in the study underwent four stages of evaluation. As early 2 and 2 after one week. All participants were assessed with RDC / TMD and to exclude any sign or symptom of TMD and clinical condition. They evaluated the movements of opening; Obliquity, rotation, Translation / Antero-posterior, lateral-lateral and vertical movement. Results: 17 articles evaluated and studied three-dimensional dispisitivos demonstrated methodological differences regarding the types of models and variables to be studied. In the opening movement of the present results are promising because it presented ICC considered excellent (0.48 to 1.32). However for the laterality movements it needs a certain amount of caution because the results ranged from "poor" good "reproducibility (0.30 to 0.57). Conclusion: There is no scientific evidence of the clinical application of any of the models of kinematics evaluation of the jaw. The three-dimensional model is reproducible to be opening Intra / Inter days and Intra / Inter evaluators and less reproducible lateral excursions for intra / inter-day and inter evaluators. / Introdução: A Articulação temporomandibular (ATM) faz parte do sistema estomatognático (SE) e é responsável pela sucção, mastigação, fala, deglutição. A cinemática é uma ferramenta confiável para avaliação quantitativa do movimento,que registra as trajetórias de marcadores fixados nos segmentos corpóreos e avalia mais precisamente o movimento humano. Objetivo: Realizar uma revisão sistemática do uso da avaliação cinemática na ATM e sua aplicabilidade e propor a análise da reprodutibilidade cinemática da mandíbula por meio de um instrumento tridimensional durante atividades funcionais. Material e Métodos: Foram consultadas as seguintes bases de dados: BIREME, Periódicos Capes, PubMed, Science Direct, Scielo e Pedro. Os termos de busca utilizados foram:” Kinematics”, “Temporomandibular Joint”, “CentricRelation”, “Movements”, “Patient-SpecificModeling”, “MovementDisorders” em inglês e português. Após a busca independente de dois revisores, foram encontrados 40 artigos e, após a aplicação dos critérios de exclusão, 17 artigos foram selecionados para a análise. Os participantes incluídos no estudo foram submetidos a 4 fases de avaliação. Sendo 2 iniciais e 2 após uma semana. Todos os participantes foram avaliados com RDC/TMD para excluir qualquer sinal e ou sintoma de DTM e a condição clínica. Foram avaliados os movimentos de Abertura; Obliquidade, Rotação, Translação/Antero-posterior, Látero-lateral e Movimento Vertical. Resultados: Os 17 artigos avaliados estudaram dispisitivos tridimensionais e demonstraram diferenças metodológicas a respeito dos tipos de modelos e variáveis a serem estudadas. No movimento de abertura os resultados do modelo tridimensional são promissores, pois apresentaram ICC considerado excelente (0,48 a 1,32). No entanto para os movimentos de Lateralidade é necessário ter uma certa cautela pois os resultados variaram de “pobre a “boa” reprodutibilidade (0,30 a 0,57). Conclusão: Não há evidencia cientifica da aplicação clínica de nenhum dos modelos de avaliação cinemática da mandibula. O modelo tridimensional é reprodutível para Abertura seja Intra/Inter dias e Intra/Inter avaliadores e menos reprodutível para as Lateralidades intra/inter dias e inter avaliadores.

Los trastornos mandibulares son alteraciones asociadas al dolor y disfunción de la Articulación Temporomandibular (ATM), a los músculos de la masticación, a la limitación del movimiento mandibular y a la presencia de un click articular. Entre estos trastornos se puede encontrar la hipomovilidad mandibular la cual se caracteriza por la incapacidad del paciente de abrir la boca con una amplitud normal. La hipomovilidad asociada a la contractura muscular tiene como tratamiento de primera opción el estiramiento pasivo, en esta técnica el paciente tiene que abrir la boca hasta el límite máximo, este movimiento debe ser realizado durante 5 o 6 veces al día. Este reporte de caso describe una paciente de 46 años de edad con Hipomovilidad Mandibular por contractura muscular, se describe la sintomatología, la evaluación clínica y el tratamiento propuesto. La evolución fue favorable; en un seguimiento de 5 semanas se logró el objetivo propuesto. / Mandibular disorders are disorders associated with the pain and dysfunction of the Temporomandibular Joint, the chewing muscles, the limitation of mandibular movement and the presence of a joint click. Among these disorders can be found mandibular hypomobility which is characterized by the patient's inability to open the mouth with a normal width. Passive stretching is the first option for hypomobility associated with muscle contraction. In this technique, the patient has to open the mouth to the maximum limit, this movement must be carried out 5 or 6 times a day. This case report describes a 46-year-old patient with Mandibular Hypomobility due to muscle contracture, the symptoms, the clinical evaluation and the proposed treatment are described. The evolution was favorable; in a 5-week follow-up, the proposed objective was achieved. / Trabajo académico

Energy densities (ED, mJ/mm3) quantify mechanical work imposed on articular cartilages during function. This cross-sectional study examined differences in temporomandibular joint (TMJ) ED during asymmetric versus symmetric jaw closing in healthy females versus males. ED component variables were tested for differences between and within sexes for two types of jaw closing. Seventeen female and 17 male subjects gave informed consent to participate. Diagnostic criteria for temporomandibular disorders and images (magnetic resonance (MR), computed tomography) were used to confirm healthy TMJ status. Numerical modelling predicted TMJ loads (Fnormal) consequent to unilateral canine biting. Dynamic stereometry combined MR imaging and jaw-tracking data to measure ED component variables during 10 trials of each type of jaw closing in each subject's TMJs. These data were then used to calculate TMJ ED during jaw closing asymmetrically and symmetrically. Paired and Student's t tests assessed ED between jaw closing movements and sexes, respectively. Multivariate data analyses assessed ED component variable differences between jaw closing movements and sexes (α = 0.05). Contralateral TMJ ED were 3.6-fold and significantly larger (P <.0001) during asymmetric versus symmetric jaw closing, due to significantly larger (P ≤.001) distances of TMJ stress-field translation in asymmetric versus symmetric movement. During asymmetric jaw closing, contralateral TMJ ED were twofold and significantly larger (P =.036) in females versus males, due to 1.5-fold and significantly smaller (P ≤.010) TMJ disc cartilage volumes under stress fields in females versus males. These results suggest that in healthy individuals, asymmetric compared to symmetric jaw closure in females compared to males has higher TMJ mechanical fatigue liabilities.

Objectives: To determine whether dolichofacial (Frankfort horizontal mandibular plane angle (FHMPA) ≥30°) vs brachyfacial (FHMPA ≤22°) phenotypes differ in temporomandibular joint (TMJ) loads and whether these differences correlate longitudinally with mandibular ramus height (Condylion-Gonion, Co-Go). Setting and Sample Population: Lateral and posteroanterior cephalographs from ten dolichofacial and ten brachyfacial individuals made at average ages of 6 (T1), 12 (T2) and 18 (T3) years and available online (http://www.aaoflegacycollection.org/aaof_home.html) were used. Materials and Methods: Three-dimensional anatomical data were derived from cephalographs and used in numerical models to predict TMJ loads for a range of biting angles on incisors, canines and first molars. Two criteria were used to define clinically important between-group TMJ load differences: statistical significance was defined with a two-group t-test, and where differences were also ≥20%. A statistical approach called response surface analysis was used to assess correlation between TMJ loads and its predictors considered in this study. Results: The two phenotypes had significantly different FHMPA at all ages (P<.05). No differences in TMJ loads were found at T1. Ipsilateral and contralateral TMJ loads at T2 and T3 were significant and ≥20% larger in dolichofacial than brachyfacial phenotypes for specific biting angles (all adjusted P<.05). Regression analysis indicated age and ramus height contribute 53% of the variability in normalized values of TMJ loads. At higher ages, dolichofacial phenotypes had significantly higher TMJ loads which were correlated with shorter ramus heights compared to brachyfacial phenotypes. Conclusions: Craniofacial mechanics may explain, in part, mandibular growth differences between dolichofacial and brachyfacial phenotypes.

Objectives: To test whether mechanobehaviour (temporomandibular joint (TMJ) loads, jaw muscle use) was different between facial types and correlated with ramus height (Condylion-Gonion, mm). Setting and Sample Population: University of Missouri-Kansas City (UMKC) Orthodontic Clinic. Ten dolichofacial and ten brachyfacial adolescents (Sella-Nasion–Gonion-Gnathion (SN-GoGn) angles ≥37° and ≤27°, respectively) consented to participate. Materials and Methods: Numerical models calculated TMJ loads for a range of static biting based on subjects’ three-dimensional anatomy. Subjects were trained to record jaw muscle electromyography (EMG) over 2 days and 2 nights in their natural environments. Laboratory EMG/bite-force calibrations determined subject-specific EMG for 20 N bite-force (T20Nave). Jaw muscle use via duty factors (DF=muscle activity duration/total recording time, %) was determined from day and night recordings for muscle-specific thresholds from ≥5% to ≥80%T20Nave. ANOVA and Tukey's HSD post hoc tests assessed for group differences in mechanobehaviour (TMJ loads, DFs). Regression modelling correlated subjects’ normalized TMJ loads, DFs and ramus height. Results: Dolichofacial compared to brachyfacial subjects produced significantly higher (P<.05) TMJ loads, where ipsilateral loads were ≥20% larger for some biting angles, but had significantly less (all P<.05) masseter (day, night) and temporalis (night) DFs. Regression analysis showed a significant relationship amongst normalized TMJ loads, masseter DF and ramus height (R2=.49). Conclusions: Mechanobehaviour showed significant differences between facial types and was correlated with ramus height.

Indiana University-Purdue University Indianapolis (IUPUI) / Previous studies have shown an increased growth of the tibial growth plate in rats infused with supraphysiologic doses of IGF-I. However, no one has demonstrated this effect on the TMJ in vivo. To determine the effect of a constant infusion of IGF-1 on the TMJ, 20 Sprague-Dawley rats were divided into three groups: (1) control, (2) surgical control, and (3) IGF-1 and placebo infused. IGF-I was delivered at a rate of 1 μg/day over the TMJ via osmotic minipumps. lntravital bone labels were administered at two-week intervals to monitor growth rate. Following sacrifice, seven mandibular (Mn) dimensions were measured anthropometrically. The mandibles were then imbedded in acrylic and stained with tetrachrome to visualize the Mn cartilage. Fluorescence microscopy was utilized to measure the Mn growth between bone labels and calculate growth rates. In addition, the hypertrophic cartilage layer thickness was measured photomicrographically. ANOVA showed no significant difference (P<0.05) in growth rates or cartilage thicknesses between the groups. However, multiple t tests did show an increase in several Mn dimensions (increase in length from gonion to the mental foramen; increase in length from condylion to the mental foramen; and increase in condylar head anterior-posterior length) in the experimental animals comparing the IGF-I infused side with the placebo infused control side. Therefore, it was concluded that IGF-I, when infused at a constant supraphysiologic dose, may increase mandibular growth in certain directions. The present study is not able to definitively demonstrate that these increases are due to direct effects on Mn cartilage growth.

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Nesta pesquisa, realizou-se o estudo dos movimentos de abertura e fechamento da mandíbula por meio de recursos da optoeletrônica para a obtenção e avaliação dos seus centros instantâneos de rotação. Os dados foram obtidos por duas câmeras filmadoras digitais e o processamento das imagens foi realizado por um software de computador desenvolvido junto ao Departamento de Engenharia Mecatrônica da Escola Politécnica da Universidade de São Paulo. Foram realizadas filmagens de dois pacientes, um sem sinais e sintomas de disfunção temporomandibular (DTM) e outro com deslocamento anterior unilateral do disco articular. Foi desenvolvida uma estrutura removível fixada aos dentes dos pacientes, que por meio de hastes metálicas, permitiu projetar para a porção extra-oral, o movimento da mandíbula, com pontos de referência (alvos) fixados à mesma. Foram realizadas duas filmagens do movimento de abertura e fechamento de cada paciente, uma a partir da posição de máxima intercuspidação (MIC) e outra com a mandíbula sob retrusão manual. As sequências de imagens obtidas geraram arquivos de dados em forma de coordenadas dos pontos correspondentes à variação do movimento dos alvos, bem como de suas trajetórias. Pelo processamento das imagens, foram calculados os centros instantâneos de rotação mandibular (CIRs), resultando em subsídios para análise clínica. Os resultados demonstraram que: o método desenvolvido foi capaz de capturar e processar o movimento mandibular de abertura e fechamento em um plano tridimensional de forma dinâmica, produzindo dados palpáveis para análise clínica; que foi possível, com nível de grandeza na ordem de pixels, analisar o comportamento dos CIRs da mandíbula e de toda a face dos pacientes; os CIRs se encontraram em regiões diferentes durante o movimento de abertura e fechamento com ou sem retrusão manual e com ou sem DTM; a localização dos CIRs esteve próxima à região de ATM quando se executou o movimento de abertura e fechamento com retrusão mandibular, e próximos ao forame mandibular, quando se executou o movimento de abertura e fechamento natural a partir da posição de MIC. / This study assessed the mandibular instantaneous center of rotation (ICR) of mandibular opening and closing movement using the optoelectronic method. Two digital camcorders provided the images and the data were evaluated by a software developed by the Department of Mechatronic Engineering, Polytechnic School- USP. The images were obtained from two patients, one without signs and symptoms with concerns on temporomandibular disorders and the other with unilateral disc displacement. A removable structure attached to patients teeth allowed recording references points outside of the mouth. Two movies of mandibular opening and closing movement were made of each patient, one starting from intercuspal position and the other starting from a forced retrusive mandible position. The images sequence was use to produce the location data from the references points pathway. The software processed the data and the ICR was determined to provide clinical analysis parity. Optoelectronic method can be used to analyze the mandibular three-dimensional movements and could be applied to the clinical evaluation. Also, the method allowed the assessment of the ICR and the patients faces in pixels magnitude. The ICR were detect in different regions of the mandible during the opening and closing mandibular movements of each condition. When patients started the mandibular movements from the forced retrusive position, the ICR was situated near the temporomandibular joint and, when patients started the movements from the intercuspal position, the ICR was located near the mandibular foramen.

A proposta deste trabalho foi analisar os efeitos da laserterapia de baixa potência(LLLT) no comportamento nociceptivo e na atividade neuronal do núcleo trigeminal após lesão unilateral do disco da articulação temporomandibular (ATM) em ratos. Foram utilizados 40 ratos. Foi realizado acesso cirúrgico na ATM sob anestesia geral. Os animais foram divididos em 4 grupos (n=10): Grupo 1: Lesão cirúrgica do disco articular e LLLT; Grupo 2: Sham - operado e LLLT; Grupo 3: Lesão cirúrgica do disco articular; Grupo 4, Naive: controle sem lesão articular ou LLLT. Foram realizadas 10 sessoes de LLLT com laser de GaAs com comprimento de onda de 904 nm e densidade de energia 6J/cm2.O desenvolvimento de sintomas neuropáticos foi avaliado pelo teste de Von Frey. As amostras do gânglio trigêmeo foram preparadas para determinação da expressão proteica da substancia P (SP), do receptor de potencial transiente vaniloide do subptipo-1 (TRPV-1) e do peptídeo relacionado ao gene da calcitonina (CGRP). Análise estatística foi realizada (p<0,050). Houve reversão total do limiar nociceptivo, a partir da primeira sessão no grupo1, e a partir da segunda sessão no grupo 2, e se manteve até a décima sessão. Houve um aumento da expressão de SP, TRPV-1 e CGRP no gânglio trigeminal no grupo 3 e uma diminuição significativa após a LLLT no grupo 1. Foi concluído que o uso da laserterapia tem efetividade para diminuição do comportamento nociceptivo, e que seu uso nesse modelo de lesão experimental se mostrou viável para estudo experimental das disfunções temporomandibulares. / The purpose of this study was to analyze the effects of low level laser therapy (LLLT) on nociceptive behavior and trigeminal nucleus neuronal activity after unilateral temporomandibular joint (TMJ) disc injury in rats. 40 rats were used. Surgical access to TMJ under general anesthesia was performed. The animals were divided into 4 groups (n = 10): Group 1: Surgical lesion of the articular disc and LLLT; Group 2: sham operated and LLLT; Group 3: Surgical lesion of the articular disc; Group 4, Naive: control without joint injury or LLLT. Ten sessions of LLLT were performed with GaAs laser with wavelength of 904 nm and energy density 6J / cm2. The development of neuropathic symptoms was evaluated by the von Frey test. The trigeminal ganglion samples were prepared for determination of the protein expression of substance P (SP), vanilloid transient potential receptor of subtype-1 (TRPV-1) and peptide related to the calcitonin gene (CGRP). Statistical analysis was performed (p <0.050). There was a total reversal of the nociceptive threshold, from the first session in group1, and from the second session in group 2, and remained until the tenth session. There was an increase in the expression of SP, TRPV-1 and CGRP in the trigeminal ganglion in group 3 and a significant decrease after LLLT in group 1. It was concluded that the use of laser therapy is effective in reducing nociceptive behavior, and that the use of this Model of experimental lesion proved to be feasible for the experimental study of temporomandibular disorders.