Orientador: José Geraldo Trani Brandão / Banca: Marcelo Sampaio Martins / Banca: Messias Borges Silva / Banca: Marta Solange Rampani / Banca: Cristina de Carvalho Ares Elisei / Resumo: O tratamento das desordens temporomandibulares toma como base as informações colhidas durante a anamnese e o exame clínico do indivíduo. Com o objetivo de melhor compreensão da fisiopatologia que afeta os músculos do sistema estomatognático, o estudo da força destes músculos, tem sido incluído em muitos trabalhos, pois ajuda na escolha de um tratamento e verifica a eficiência do tratamento. O objetivo geral desse estudo foi construir um gnatodinamômetro com interface computacional a fim de analisar e comparar a força dos músculos da mastigação durante um experimento para mensuração da força de mordida na região dos incisivos. Para análise estatística, aplicou-se o teste de hipótese t a fim de comparar os valores das médias de indivíduos com e sem Disfunção Temporomandibular muscular. A amostra foi composta por 10 indivíduos com desordem temporomandibular sendo 5 mulheres e 5 homens e 10 indivíduos sadios, sendo 5 mulheres e 5 homens para controle, sem sinais ou sintomas de desordens temporomandibulares, segundo a classificação proposta pelo protocolo do Research Diagnostic Criteria for Temporomandibular Disorders. A mensuração da força de mordida foi realizada na clínica de desordens temporomandibular da AOESP. Conclui-se que existe diferenças estatísticas no valor médio da força de mordida, entre os grupos com DTM muscular e grupo Controle. Indivíduos sadios possuem valor médio de força de mordida maior em relação aos portadores de DTM. Indivíduos do gênero masculino possuem valor médio da força de mordida maior em relação ao gênero feminino. Obteve-se ainda neste estudo uma proposta de um gnatodinamômetro para análise da força dos músculos estomatogmático / Abstract: The treatment of temporomandibular disorders builds on the information collected during history taking and clinical examination of the individual. Aiming at a better understanding of the pathophysiology that affects the muscles of the stomatognathic system, the study of the strength of these muscles, has been included in many studies as it helps in choosing a treatment and verifies the effectiveness of the treatment. The general objective of this study was to build a gnathodynamometer with computer interface to analyze and compare the strength of the muscles of mastication during an experiment to measure the bite force in the incisor region. Statistical analysis was applied to hypothesis test to compare the mean values for subjects with and without TMD muscle. The sample consisted of 10 healthy subjects and 5 women and 5 men and 10 subjects with temporomandibular disorder, 5 women and 5 men to control, without signs or symptoms of temporomandibular disorders, according to the classification proposed by the protocol of the Research Diagnostic Criteria for Temporomandibular disorders. Measurement of bite force was held in temporomandibular disorders clinic AOESP. We conclude that there is no statistical differences in the mean bite force between the muscle groups with TMD and control group. Healthy individuals have an average value of greater bite force in relation to TMD. Male individuals have average bite force higher compared to females. It was also observed in this study a proposal for a gnathodynamometer strength analysis of stomatognathic muscles / Doutor

Thesis (Ph.D.)--University of Hong Kong, 1994. / Includes bibliographical references. Also available in print.

Thesis (Ph.D.)--University of Hong Kong, 1994. / Includes bibliographical references. Also available in print.

published_or_final_version / Dental Surgery / Master / Master of Dental Surgery

Objective: To evaluate three-dimensional position of the TMJ condyle within the glenoid fossa in different types of skeletal patterns. Materials and methods: Ninety CBCT images were consecutively selected and divided into skeletal class I, class II and class III. The images were analyzed locating landmarks in the different areas of the condyle and glenoid fossa. All landmarks presented acceptable reliability. The mean results were compared using ANOVA and Bonferroni post-hoc test (p < 0.05). Results: There was a tendency for the anterior joint space to be smaller than the posterior joint space. Statistical analysis, however, evidenced no significant differences between the anterior, superior and posterior joint spaces and the different skeletal patterns or between sides. Conclusion: There was non-concentricity of the condyle for all the groups studied, and no particular direction was statistically significantly favored. It is unclear whether the differences found would be clinically significant, considering anatomical individual variations.

Thesis (M.Tech.: Chiropractic) -Dept. of Chiropractic, Durban Institute of Technology, 2002 / The purpose of this randomized controlled clinical trial was to investigate the relative effectiveness of proprioceptive neuromuscular facilitation (PNF) versus ultrasound therapy for the treatment of Temporomandibular joint (TMJ) dysfunction caused by masticatory myofascial trigger points, in terms of subjective and objective clinical findings.

A dissertation presented to the Faculty of Health Sciences at the Durban University of Technology in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, 2009 / Introduction: The aetiology of Temporomandibular Joint Dysfunction (TMJD) is not fully understood and the treatment of TMJD is controversial. Most treatment plans are based on postulated aetiology. Treatment plans currently range from pharmacological to surgical and occasionally physical therapy is also used for any myofascial component. Myofacial Trigger Points (MFTP’s) in the head and neck region have similar pain referral patterns as TMJD and there is overlap in aetiology and epidemiology. If correlation can be proved to exist between the severities of TMJD and MFTP’s then the treatment of MFTP’s can potentially decrease the severity of TMJD and then the more radical treatments can be avoided. Objectives: To determine whether TMJD was present and establish severity. To locate any MFTP’s in the Sternocleidomastiod (SCM), Temporalis, Masseter, Posterior Cervical (PC), Lateral and Medial Pterygoid muscles and determine their severity. Methods: A random sample of 25 participants were evaluated. A p value <0.05 was considered as statistically significant. Quantitative variables were summarized using median, inter-quartile range and range due to skewness of distribution, while categorical variables were described using frequency distributions and bar charts. Spearman’s nonparametric correlation analysis, and curve estimation were used to determine the existence of a relationship between TMJ severity and MFTP severity. A scatterplot was used to graphically assess the relationship. Conclusion: The results suggested that the participants were actually chronic neck pain suffers that developed TMJD over the long term as a result of chronic neck pain changing the kinematic biomechanics or as a result of a completely different and independent event as suggested by Foreman and Croft (1995).

Imaging of the osseous structures of the temporomandibular joint is best accomplished using computed tomography (CT). Cone beam CT offers a reduced radiation dose and improved spatial resolution compared to multislice helical CT. This study evaluates comparative dosimetry for temporomandibular joint imaging using two different cone beam CT systems, the Hitachi CB MercuRay and Kodak 9000 3D. These systems demonstrate differing properties with respect to field-of view sizes, operational technique factors, and spatial resolution. The Kodak 9000 3D unit offers an effective radiation dose reduction of greater than ten-fold compared with the Hitachi CB MercuRay, depending on kVp and mA. A subsequent clinical study evaluating the effect of spatial resolution on the ability to detect osseous changes related to temporomandibular joint degenerative disease found no significant difference in diagnostic efficacy between high and low spatial resolution images, however, observers consistently associated high spatial resolution with superior image quality.

Imaging of the osseous structures of the temporomandibular joint is best accomplished using computed tomography (CT). Cone beam CT offers a reduced radiation dose and improved spatial resolution compared to multislice helical CT. This study evaluates comparative dosimetry for temporomandibular joint imaging using two different cone beam CT systems, the Hitachi CB MercuRay and Kodak 9000 3D. These systems demonstrate differing properties with respect to field-of view sizes, operational technique factors, and spatial resolution. The Kodak 9000 3D unit offers an effective radiation dose reduction of greater than ten-fold compared with the Hitachi CB MercuRay, depending on kVp and mA. A subsequent clinical study evaluating the effect of spatial resolution on the ability to detect osseous changes related to temporomandibular joint degenerative disease found no significant difference in diagnostic efficacy between high and low spatial resolution images, however, observers consistently associated high spatial resolution with superior image quality.

Objective: To evaluate three-dimensional position of the TMJ condyle within the glenoid fossa in different types of skeletal patterns. Materials and methods: Ninety CBCT images were consecutively selected and divided into skeletal class I, class II and class III. The images were analyzed locating landmarks in the different areas of the condyle and glenoid fossa. All landmarks presented acceptable reliability. The mean results were compared using ANOVA and Bonferroni post-hoc test (p < 0.05). Results: There was a tendency for the anterior joint space to be smaller than the posterior joint space. Statistical analysis, however, evidenced no significant differences between the anterior, superior and posterior joint spaces and the different skeletal patterns or between sides. Conclusion: There was non-concentricity of the condyle for all the groups studied, and no particular direction was statistically significantly favored. It is unclear whether the differences found would be clinically significant, considering anatomical individual variations.