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PURPOSE: It has been suggested in some studies that certain malocclusion features are related to Temporomandibular Joint (TMJ) clicking, which is a prevalent sign of Temporomandibular Disorders (TMD’s). This study aimed to evaluate different dental and skeletal malocclusion parameters and their relation to TMJ sounds. Also, to examine TMJ sounds with the presence of headache and TMJ pain using Diagnostic Criteria for Temporomandibular Disorders. MATERIALS & METHODS: A sample of 460 subjects seeking orthodontic treatment were evaluated using DC/TMD. Dental measures were recorded based on the initial records along with the clinical examination of the DC/TMD. Skeletal measurements were recorded after lateral cephalometric radiographs were traced. All measurements were confirmed before collection by one examiner using all the initial records. RESULTS: The sample was comprised of 283 females and 177 males. Clicking prevalence among the sample was 13%, of which 70% were females. Hispanic and Other group were significantly associated with opening and closing TMJ click. Class III dental was highly significant with TMJ click (OR: 0.35). Females who had headache had higher odds of having headache compared to males. Headache was significantly associated with all TMJ click variables (Open click [OR:10], lateral click [OR:10], self-reported click [OR:4.7]). Moreover, TMJ pain was significant with open click (OR:7.6), lateral click (OR:14.4), and self-reported click (OR:7.7). African-American group had 0.28 odds of having TMJ pain compared to Hispanics and Other. Finally, Males have 0.29 odds of having TMJ pain compared to females. CONCLUSION: In conclusion TMJ click upon opening and closing, lateral excursion, and self-reported click is highly associated with headache and chronic headache in general with a prevalence higher in females. Pain was highly associated with TMJ click of all sorts, with a higher prevalence in females and the Hispanic and other group. Finally, TMJ click was found more in the Hispanic and other group and class III dental occlusion subjects.

Tese de mestrado integrado. Engenharia Civi l- Estruturas. Faculdade de Engenharia. Universidade do Porto. 2010

This thesis discusses the illness experience of people living with chronic pain resulting from Temporomandibular disorders (TMD). The literature discusses various aspects of the experience of chronic pain, but there is little research reported specifically on the experience of living with TMD. Using analysis of sufferers' narratives, I discuss common explanatory models and coping strategies. I then present aspects of the bodily experience of TMD as seen in people with comorbid illnesses. The personal or mental aspects of TMD are explored, particularly in terms of fear, anxiety, and hope for the future. Lastly, the broader impacts of TMD are explored through sufferers' relationships with friends and family, and sufferers' ability to function in social contexts. It is concluded that TMD impacts many areas of sufferers' lives, and that the lived experience extends beyond diagnosis and treatment seeking to include the day to day management of TMD pain.

The purpose of this study was to evaluate masticatory muscle (MM) and temporomandibular joint (TMJ) pain patients regarding the prevalence of Posttraumatic Stress Disorder (PTSD) symptoms, and evaluate the level of psychological dysfunction and its relationship to PTSD symptoms in these patients. This study included 445 adult patients (male = 42, female = 403). Psychological questionnaires included the Symptom Check List-90-Revised (SCL-90-R), the Multidimensional Pain Inventory, the Pittsburgh Sleep Quality Index and the PTSD Check List Civilian. The total sample of patients was divided into two major groups: The MM group (n=242) and TMJ group (n=203). Each group was divided into three subgroups according to the presence of a stressor and severity of PTSD symptoms. Thirty six patients (14.9%) in the MM group and 20 patients (9.9%) in the TMJ group presented symptomatology of PTSD. MM and TMJ pain patients in the positive PTSD subgroups scored higher on all scales of the SCL-90-R (p = .000) than the other two subgroups and reached levels of distress that were indicative of psychological dysfunction. MM and TMJ pain patients in the positive PTSD subgroups were more often classified as dysfunctional than as adaptive copers and presented with more sleep disturbances than patients in the no stressor and negative PTSD subgroups. A somewhat elevated prevalence rate for PTSD symptomatology was found in the MM than in the TMJ group. Significant levels of psychological dysfunction appear limited to temporomandibular disorder patients with symptoms of PTSD.

Abstract The fact that the lateral pterygoid muscle (LPM) and related symptoms play an important role in temporomandibular disorders (TMD) is widely recognized. In the study reported here, the LPM was investigated by magnetic resonance imaging (MRI) of patients with TMD. The visibility of the LPM in MRI with different projections was analyzed and a new imaging projection, condyle-the lateral pterygoid muscle projection (CLPM), for the LPM in MRI was introduced. Normal and abnormal findings of the LPM was compared with clinical symptoms of TMD. Compared with sagittal imaging of temporomandibular joint (TMJ), CLPM images and most of the oblique sagittal imaging were able to show the LPM clearly. Hypertrophy, atrophy and contracture of the LPM were found in TMJs either with disc in normal position or with disc displacements. Pathological changes of the superior belly and hypertrophy of the inferior belly combined with various pathological changes of the superior belly were the most frequently observed abnormal imaging findings of the LPM in TMD. The pathological changes of the LPM were associated with the main clinical symptoms of TMD. In patients with symptomatic condyle hypermobility, the pathological changes of the LPM and related symptoms were associated with the clinical symptoms of TMJs with disc in normal position. The imaging abnormalities of the LPM were common in TMJs with disc displacements and seemed to be fewer in condyle hypomobility cases in TMJs with anterior disc displacement with non-reduction (ADDnr). However, normal imaging of the LPM was also found in TMJs with severe osteoarthritic changes and disc displacement. The recognition of muscle alterations may lead to a more specific diagnosis and improve the understanding of the clinical symptoms and disease pathophysiology of TMD.

Aim: The purpose of the study is to investigate the flexural strength of polymers (PMMA) intended for stabilization splints produced by heat-activated polymerization or milling, as well as how the flexural strength is affected wear.   Material and Methods: Twelve rectangular specimens in the dimensions 64 x 10 x 3 mm were produced by milling and divided into two groups: F (milled) and FS (milled subjected to wear testing). Another twelve specimens in the same dimensions were produced by heat-activated polymerization by pressing and divided into two groups: V (heat polymerized) and VS (heat polymerized subjected to wear testing). The specimens were divided into four groups depending on the material and production technique and test method, and subjected to thermocycling, wear and flexural strength test. The result was analyzed with One-way ANOVA, Tukey’s test and a significance level of α = 0.05.   Results: The milled group had a significantly higher flexural strength compared to the other groups (p < 0.05). However, statistically, no significant differences were found between the other groups FS, V and VS (p > 0.05).   Conclusion: The flexural strength of heat-activated and milled PMMA materials was higher than the minimum requirement for flexural strength for occlusal splints, providing mechanical conditions for the materials to be used in the oral environment.   Milled PMMA exhibit higher flexural strength compared to heat-activated PMMA.               Wear (brushing) affect the flexural strength of milled PMMA negatively. / Syfte Syftet med föreliggande studie är att undersöka böjhållfastheten hos polymerer (PMMA)avsedda för stabiliseringsskenor framställda med varmpolymerisering eller fräsning, samthur böjhållfastheten påverkas av slitage. Material och metod Tolv rektangulära provkroppar med måtten 64 x 10 x 3mm framställdes genom fräsningoch delades in i två grupper: F (frästa) och FS (frästa utsatta för slitagetest). Ytterligare tolvprovkroppar i samma mått framställdes genom varmpolymeriserad pressningsteknik ochdelades in i två grupper: V (varmpolymeriserade) och VS (varmpolymeriserade utsatta förslitagetest). Provkropparna delades in i fyra grupper beroende på material,framställningsteknik och testmetod och utsattes för termocykling, slitage ochböjhållfasthetstest. Resultatet analyserades med One-way ANOVA, Tukey’s test ochsignifikansnivån sattes till α = 0,05. Resultat Den frästa gruppen (F) uppvisade signifikant högre böjhållfasthet jämfört med övrigagrupper (p < 0,05). Mellan de andra grupperna FS, V och VS påvisades inga statistisktsignifikanta skillnader (p > 0,05). Slutsats Med reservation för de begränsningar som studien har kan följande slutsats dras: • Böjhållfastheten hos varmpolymeriserad och fräst PMMA är högre än det minimalakravet på böjhållfasthet för PMMA för stabiliseringsskenor, vilket ger materialenmekaniska förutsättningar att användas i den orala miljön. • Fräst PMMA uppvisar högre böjhållfasthet än varmpolymeriserad PMMA. • Slitage (borstning) påverkar böjhållfastheten hos fräst PMMA negativt.

Esta dissertação propõe uma solução padronizada de aplicação de Tuned-Mass Damper (TMD) para controle de vibrações em lajes baseada na análise das características de carregamentos associados à utilização humana e nas características estruturais mais comuns à engenharia contemporânea. De modo a simplificar sua aplicação técnica, a sintonização é proposta por meio da escolha de componentes pré-determinados para a montagem do TMD e pela distribuição e posicionamento dos mecanismos. A eficácia do sistema é então verificada em um estudo de caso, usando um modelo de elementos finitos de uma laje, antes e depois da aplicação dos mecanismos. / This thesis proposes a standardized solution for the application of Tuned-Mass Dampers to the control of floor vibrations based on the characteristics of the acting loads associated to human usage and the characteristics of the most common structures of the contemporary engineering practice. In order to simplify its usage by the technical community, the tuning is proposed through the selection of pre-determined components for the assembly of the TMD and the choice of disposition and spacing of the mechanisms. The system efficacy is then verified in a computational case study, by means of a finite-element model of a floor, before and after the application of the mechanisms.

Esta dissertação propõe uma solução padronizada de aplicação de Tuned-Mass Damper (TMD) para controle de vibrações em lajes baseada na análise das características de carregamentos associados à utilização humana e nas características estruturais mais comuns à engenharia contemporânea. De modo a simplificar sua aplicação técnica, a sintonização é proposta por meio da escolha de componentes pré-determinados para a montagem do TMD e pela distribuição e posicionamento dos mecanismos. A eficácia do sistema é então verificada em um estudo de caso, usando um modelo de elementos finitos de uma laje, antes e depois da aplicação dos mecanismos. / This thesis proposes a standardized solution for the application of Tuned-Mass Dampers to the control of floor vibrations based on the characteristics of the acting loads associated to human usage and the characteristics of the most common structures of the contemporary engineering practice. In order to simplify its usage by the technical community, the tuning is proposed through the selection of pre-determined components for the assembly of the TMD and the choice of disposition and spacing of the mechanisms. The system efficacy is then verified in a computational case study, by means of a finite-element model of a floor, before and after the application of the mechanisms.

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