Introduction: Temporomandibular disorder (TMD) is a multifactorial disease. For this reason, it is difficult to obtain an accurate and correct diagnosis. In this context, conservative treatments, including therapeutic exercises classified as stretching, relaxation, coordination, strengthening and endurance, are oftentimes prescribed. Objective: Thus, the aim of the present article was to conduct a literature review concerning the types of exercises available and the efficacy for the treatment of muscular TMD. Methods: The review included researches carried out between 2000 and 2010, indexed on Web of Science, PubMed, LILACS and BBO. Moreover, the following keywords were used: Exercise, physical therapy, facial pain, myofascial pain syndrome, and temporomandibular joint dysfunction syndrome. Studies that did not consider the subject "TMD and exercises", used post-surgery exercises and did not use validated criteria for the diagnosis of TMD (RDC/TMD) were not included. Results: The results comprised seven articles which proved therapeutic exercises to be effective for the treatment of muscular TMD. However, these studies are seen as limited, since therapeutic exercises were not applied alone, but in association with other conservative procedures. In addition, they present some drawbacks such as: Small samples, lack of control group and no detailed exercise description which should have included intensity, repetition, frequency and duration. Conclusion: Although therapeutic exercises are considered effective in the management of muscular TMD, the development of randomized clinical trials is necessary, since many existing studies are still based on the clinical experience of professionals.Keywords: Temporomandibular joint dysfunction syndrome. Myofascial pain syndromes. Physical therapy modalities. Exercise.Introdução: a disfunção temporomandibular (DTM) é uma doença multifatorial, geralmente com evolução benigna. Por esse motivo, é difícil a obtenção de um diagnóstico inicial preciso e correto, levando a um consenso na prescrição de tratamentos conservadores, entre eles, os exercícios terapêuticos, que são classificados em exercícios de alongamento, relaxamento, coordenação, fortalecimento e resistência. Objetivo: o objetivo desse estudo foi realizar uma revisão de literatura dos trabalhos que apresentam os tipos de exercícios disponíveis e sua eficácia para o tratamento das DTM musculares. Métodos: foi feito um levantamento bibliográfico, de 2000 a 2010, nas bases se dados Web of Science, PubMed, LILACS e BBO, cruzando os seguintes descritores: exercise, physical therapy, facial pain, myofascial pain syndrome e temporomandibular joint disfunction syndrome. Foram excluídos os trabalhos que não consideravam o tema exercícios e DTM, utilizavam exercícios pós-cirúrgicos e que não utilizavam critérios validados para o diagnóstico da DTM (RDC/TMD). Resultados: resultaram sete artigos, que mostraram que os exercícios terapêuticos foram efetivos para o tratamento de DTM muscular. No entanto, uma das limitações desses estu...
The aim of the study was to determine and classify the shape of the mandibular fossa and the corresponding condyle in different types, relating them to sex and symmetry, in adult human skulls, from lateral, posterior and superior views. The sample included 50 human skulls from 23 to 82 years old, 32 males and 18 females. The condyle and silicone casting molds of the fossa were photographed to assess shape in the three views. Shapes were classified, validated by intra-and inter-rater analysis and frequency, sex distribution and symmetry verified. Shapes were classified as rounded, angled, flattened and mixed types in the lateral and posterior views; and as biconvex, flat-convex, biflattened and mixed in the superior view. Rounded condyle and fossa were more frequent in the lateral (57% and 66% respectively) and posterior (53% and 83%) views. In the superior view, mixed shape presented higher frequency in condyle (59%) while in fossa the biconvex shape (46%) was most common. There was no significant difference in shape distribution by sex. The same shape (symmetry) or otherwise (non-symmetry) in right and left side condyle and fossa were separately assessed and showed various combinations.
The construction of a pubovaginal sling using a low-cost polypropylene mesh is a safe and effective technique for the relief of SUI. It should be considered an alternative, especially for patients in public health systems with low financial resources.
To study optic canal dimensions and symmetry during cranial development, 146 silicon rubber left- and right-side models of the optic canal were cast from 51 dry skulls and 22 individual bones. The sample was divided in three age groups: fetuses (including newborns), children and adults with ages ranging from seven months of fetal life to 68-year-old. A digital caliper was used to measure the optic canal orbital and cranial diameters as well as model length. Results for the right and the left sides were, respectively, in millimeters: a) Maximum diameter of the orbital opening: fetuses, 4.68/4.47--children, 5.51/5.41--adults, 5.43/5.34; b) Minimum diameter of the orbital opening: fetuses, 2.89/2.84--children, 3.54/3.61--adults, 3.78/3.73; c) Diameter of the cranial opening: fetuses, 3.79/3.76--children, 4.67/4.72--adults, 5.24/5.43; d) Length of the optic canal: fetuses, 3.27/3.05--children, 3.93/3.71--adults 4.94/5.21. The diameter of the cranial opening of the optic canal increases significantly (p < 0.001) during the fetal period and throughout child and adulthood. The greater and smaller orbital apertures increase during the fetal period and during childhood, keeping the same size in adulthood. Optic canal length increases at some point between childhood and adulthood. Concerning symmetry, the only significant difference found was greater right than left optic canal diameter on the orbital side.
The results obtained allow the conclusion that the present stage T1 for renal cell carcinoma gathers tumors of different evolution, being therefore recommendable the stratification in T1a for tumors smaller than 4 cm, and T1b for tumors between 4 and 7 cm.
Based on the survey of records regarding the location and frequency of referred pain in patients with temporomandibular disorder when certain pre-established areas are palpated, we proposed an anatomical-topographical division of the head and neck to allow the standardization and reproducibility of locations of referred pain. Of the 835 charts reviewed, 419 (50.2%) patients had referred pain on palpation of the regions based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and palpation of the cervical regions, as often analyzed by the Cochran Q test. The concordance coefficient of Kendall examined the correlation between regions of referred pain concerning to palpated sites. The new regions were defined preauricular, facial lateral, temporoparietal, posterior head, posterior and lateral cervical, anterior cervical and calvaria. The region palpated that originated more referred pain was corresponding to the masseter muscle followed by the region of the sternocleidomastoid muscle, regardless of the side palpated. On palpation of the regions established by the RDC/TMD, the most frequent area of referred pain was the lateral facial region. On palpation of the neck, were the posterior and lateral cervical regions. The sites that originated more referred pain when palpated were the masseter, temporalis, sternocleidomastoid and trapezius muscles.
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