The aim of this study was to associate minor psychiatric disorders (general health) and quality of life with temporomandibular disorders (TMD) in patients diagnosed with different TMD classifications and subclassifications with varying levels of severity. Among 150 patients reporting TMD symptoms, 43 were included in the present study. Fonseca's anamnestic index was used for initial screening while axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD) was used for TMD diagnosis (muscle-related, joint-related or muscle and joint-related). Minor psychiatric disorders were evaluated through the General Health Questionnaire (GHQ) and quality of life was assessed using the World Health Organization Quality Of Life-Brief Version (WHOQOL-BREF). An association was found between minor psychiatric disorders and TMD severity, except for stress. A stronger association was found with mild TMD. Considering TMD classifications and severity together, only the item "death wish" from the GHQ was related to severe muscle-related TMD (p = 0.049). For quality of life, an association was found between disc displacement with reduction and social domain (p = 0.01). Physical domains were associated with TMD classifications and severity and the association was stronger for muscle and joint-related TMD (p = 0.037) and mild TMD (p = 0.042). It was concluded that patients with TMD require multiple focuses of attention since psychological indicators of general health and quality of life are likely associated with dysfunction.

SME and RME can be similarly indicated to correct maxillary arch constriction in patients with BCLP in the mixed dentition.

The aim of this 2-arm parallel trial was to compare the dentoskeletal effects of the expander with differential opening (EDO) and the Hyrax expander in the mixed dentition. Methods: Patients aged 7-11 years with maxillary dental arch constriction and Class I or Class II sagittal relationships were randomly allocated into 2 study groups. The experimental group comprised 22 patients (10 males, 12 females) with a mean age of 8.46 years treated with the EDO. The comparison group was composed of 24 patients (6 males, 18 females), mean age of 8.92 years treated with the conventional Hyrax expander. One complete turn per day for 6 days was performed for the posterior screw of the EDO and for the Hyrax expander. The anterior screw of the EDO was activated 1 complete turn per day for 10 days. The primary outcomes were the anterior opening of the midpalatal suture, changes on the interincisal diastema width, maxillary dental arch widths, arch perimeter, arch length, palatal depth, inclination of maxillary posterior teeth and on dental arch shape, and the amount of differential expansion in the anterior region compared with the posterior region of the maxillary dental arch. Computer-generated randomization was used. Allocation was concealed with sequentially, numbered, sealed, and opaque envelopes. Blinding was applicable for outcome assessment only. Occlusal radiographs of the maxilla were obtained at the end of the active expansion phase (T2). Intraoral photographs were obtained immediately pre-expansion (T1) and at T2. Digital dental models were obtained at T1 and 6 months after the active expansion period (T3). Intergroup comparisons of T1-T2 changes were performed using multiple linear regression analysis (P \ 0.05). The independent variables were both treatment and the starting forms. Bonferroni correction for multiple tests was applied. Results: The experimental group showed a significantly greater opening of the anterior region of the midpalatal suture, a greater increase of the interincisal diastema width, and greater increases of the intercanine distance and inter-first deciduous molar distance than the Hyrax expander. The experimental group showed a significant differential expansion between the anterior and posterior regions, whereas the Hyrax group produced a similar expansion in the canine and molar regions. Serious harm was not observed. Conclusions: The EDO was capable of promoting greater orthopedic and dental changes in the anterior region of the maxilla than the conventional Hyrax expander. Similarity between the 2 expanders was observed for changes in the posterior region width, arch perimeter, arch length, palatal depth, and posterior teeth inclination.

Both expansion procedures can be similarly indicated to correct maxillary arch constriction in patients with BCLP in the mixed dentition.

Introduction The purpose of this 2-arm parallel study was to evaluate the dentoskeletal effects of rapid maxillary expansion with differential opening (EDO) compared with the hyrax expander in patients with complete bilateral cleft lip and palate. Methods A sample of patients with complete bilateral cleft lip and palate was prospectively and consecutively recruited. Eligibility criteria included participants in the mixed dentition with lip and palate repair performed during early childhood and maxillary arch constriction with a need for maxillary expansion before the alveolar bone graft procedure. The participants were consecutively divided into 2 study groups. The experimental and control groups comprised patients treated with rapid maxillary expansion using EDO and the hyrax expander, respectively. Cone-beam computed tomography examinations and digital dental models of the maxillary dental arches were obtained before expansion and 6 months postexpansion. Standardized cone-beam computed tomography coronal sections were used for measuring maxillary transverse dimensions and posterior tooth inclinations. Digital dental models were used for assessing maxillary dental arch widths, arch perimeters, arch lengths, palatal depths, and posterior tooth inclinations. Blinding was used only during outcome assessment. The chi-square test was used to compare the sex ratios between groups (P <0.05). Intergroup comparisons were performed using independent t tests with the Bonferroni correction for multiple tests. Results Fifty patients were recruited and analyzed in their respective groups. The experimental group comprised 25 patients (mean age, 8.8 years), and the control group comprised 25 patients (mean age, 8.6 years). No intergroup significant differences were found for age, sex ratio, and dentoskeletal variables before expansion. No significant differences were found between the EDO and the hyrax expander groups regarding skeletal changes. The EDO promoted significantly greater increases of intercanine width (difference, 3.63 mm) and smaller increases in canine buccal tipping than the conventional hyrax expander. No serious harm was observed other than transitory variable pressure sensations on the maxillary alveolar process in both groups. Conclusions The EDO produced skeletal changes similar to the conventional hyrax expander. The differential expander is an adequate alternative to conventional rapid maxillary expanders when there is need for greater expansion in the maxillary dental arch anterior region. Registration This trial was not registered. Protocol The protocol was not published before trial commencement.

Este trabalho foi desenvolvido com o propósito de investigar a percepção monocular da profundidade ou relevo da máscara côncava por 29 indivíduos saudáveis, sete indivíduos com esquizofrenia sob uso de antipsicótico por um período inferior ou igual a quatro semanas e 29 sob uso de antipsicótico por um período superior a quatro semanas. Os três grupos classificaram o reverso de uma máscara policromada em duas situações de iluminação, por cima e por baixo. Os resultados indicaram que a maioria dos indivíduos com esquizofrenia inverteu a profundidade da máscara côncava na condição de observação monocular e perceberam-na como convexa, sendo, portanto, suscetíveis à ilusão da máscara côncava. Os indivíduos com esquizofrenia sob uso de medicação antipsicótica pelo período superior a quatro semanas estimaram a convexidade da máscara côncava iluminada por cima em menor comprimento comparados aos indivíduos saudáveis.

Objective: The aim of this systematic review was to analyze the short and long-term spontaneous dentoalveolar changes of the mandibular dental arch after slow (SME) or rapid (RME) maxillary expansion in the mixed and early permanent dentitions. Methods:An electronic search was performed in the following databases: PubMed/Medline, Cochrane Library, Scopus, Embase and Web of Science. Eligibility criteria for article selection included randomized controlled trials and prospective studies written in English, with no restriction of year of publication, involving patients who underwent SME or RME during the mixed or early permanent dentitions. A double-blind search of articles was performed by two reviewers. Initially, the title and the abstract of the studies were read, and their references were also hand-searched for possible missing studies. A methodological quality scoring scale was used to analyze the selected articles. Results:The search retrieved 373 articles, but only 6 were selected for review after application of the eligibility and exclusion criteria. Non-clinically significant spontaneous dentoalveolar changes of approximately 1mm were found in the mandibular dental arch in the short and long-term, after slow or rapid maxillary expansions. Furthermore, no significant differences were found between treated and control groups. Conclusions: There is enough evidence to conclude that negligible short and long-term spontaneous dentoalveolar changes tend to occur in the mandibular dental arch after SME or RME in the mixed and early permanent dentitions. More randomized studies with appropriate control group are required to better evaluate this issue.

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