A prospective, double-blind, randomized, and placebo-controlled trial was conducted in patients with chronic temporomandibular disorder (TMD) to check the analgesic efficacy of infrared low-power GaAlAs diode laser applied to acupuncture points. Forty female subjects, ranging in age from 20 to 40 years, with diagnoses of chronic myofascial pain and arthralgia were randomly allocated to two groups: an experimental group (EG) who received the laser acupuncture as adjunct to reversible occlusal splint therapy and a control group (CG) who received a placebo laser associated with occlusal splint therapy. Both approaches were applied once a week for 3 months. Laser acupuncture was defined by the following parameters: 50-mW continuous radiation for 90 s to acupoints ST6, SI19, GB20, GB43, LI4, LR3, NT3, and EX-HN3; defining 4.5-J energy; 1250-W/cm(2) density point; and 112.5-J/cm(2) total density. The outcome measurements included a symptom evolution assessment carried out by checking spontaneous and palpation pain intensity, which was indicated on a visual analog scale (VAS). All evaluations were made by an assessor who was blind to the treatment. The symptom reduction was significant in both groups (EG: VAS = 0, n = 20; CG: VAS between 2 and 4, n = 18). The measurements showed significantly faster and lower pain intensity values in the EG (p ≤ 0.002), where there was a higher proportion of patients with remission of symptoms related to the action of laser acupuncture. For patients in whom conservative treatment was adopted, the laser acupuncture is a secure, noninvasive, and effective treatment modality because it improves the chronic pain associated with TMD and has no side effects.

This study assessed the interexaminer reliability and validity of palpation (PA) and pressure pain threshold (PPT) of the temporomandibular joint (TMJ) and the masseter and temporalis muscles in patients with temporomandibular disorders (TMD) and asymptomatic controls. Eighty (80) subjects were distributed into two groups: Group 1 consisted of 40 TMD patients with muscular and joint pain selected by RDC/TMD Axis I; and Group 2 (control) with 40 asymptomatic individuals. Training and calibration of examiners was undertaken prior to testing. Mean reliability values were 0.64 and 0.78 (PPT), and 0.59 and 0.75 (PA), for patients and controls, respectively. Results showed statistically significant differences (p<0.001), for PA and PPT among TMD patients compared with the control. The results also showed acceptable specificity values (above 0.90), although sensitivity had low values. The tests had low diagnostic validity to discriminate between patients and controls, with low positive predictive values (PPV).

The aim of this study was to evaluate the presence of degenerative bone changes of the temporomandibular joint (TMJ) in individuals suffering from sleep bruxism (SB), associating these characteristics with the quality of sleep. For this, we followed the International Classification of Sleep Disorders for the diagnosis of SB, in addition to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) for the classification of TMD and cone beam computed tomography. It was found that 97.7% of the individuals with bruxism had at least 1 RDC/TMD group III diagnosis, 75.6% of the subjects considered their sleep quality as poor, and the largest group (23%) had centric bruxism. There was no significant association between the pattern of sleep quality (P = 0.36), the type of SB (P = 0.277), and the presence of degenerative changes of the TMJ. Regardless of the quality of sleep and the type of bruxism presented, the prevalence of degenerative bone disorders was high (67%) among women with a mean age of 46 years and a clinical diagnosis of SB.

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OBJETIVO: Avaliar, radiograficamente, a prevalência de alterações morfológicas do processo estilóide em pacientes com desordens temporomandibulares. MATERIAIS E MÉTODOS: Foram analisadas 1.500 radiografias panorâmicas da articulação temporomandibular de pacientes de ambos os sexos e sem limitação de idade, que foram atendidos pelo Serviço de Desordem Temporomandibular da Faculdade de Odontologia da Universidade Federal de Juiz de Fora, MG, no período de 1997 a 2003. RESULTADOS: Oitenta e três (5,53%) dos pacientes da amostra apresentaram pelo menos um dos lados da articulação com alteração morfológica do processo estilóide, sendo 74 do sexo feminino e 9 do sexo masculino, concentrados na faixa dos 41 a 50 anos de idade (32,5%). Com relação ao tipo morfológico do processo estilóide, verificaram-se 113 alongados, 21 pseudo-articulados e 19 segmentados. Constatou-se, também, que as alterações morfológicas do processo estilóide desenvolvem-se de forma simétrica. CONCLUSÃO: Em pacientes com desordem temporomandibular as alterações do processo estilóide ocorrem de forma diferenciada e de maneira simétrica em cada paciente, independentemente do sexo e da idade.

Various etiologies are attributed to the development of subjective tinnitus, but their inter-relationship with the presence of temporomandibular disorders and depression is still poorly understood. To assess the presence of depressive symptoms in individuals with TMD and subjective tinnitus, assessing the impact on their quality of life. This is a cross-sectional observational descriptive study. We evaluated 44 patients in a public University. For TMD diagnosis as well as assessment of depressive symptoms, the RDC/TMD questionnaire was used. Otolaryngological assessment was conducted by means of pure tone, speech, and immitance audiometry. The "Tinnitus Handicap Inventory" questionnaire was also administered. 84% of the individuals with tinnitus had myofascial pain, with the masseter muscle being the most prevalent area of pain, and 16% exclusively had painful and/or degenerative TMJ changes. Among the patients with myofascial pain, 86,5% had depressive symptoms, while among those without myofascial pain, only 42,8% presented these symptoms. Eleven (11) patients (25%) reported slight impact of tinnitus on quality of life, 15 (34%) mild impact, 7 (16%) moderate, 7 (16%) severe, and 4 (9%) catastrophic impact. There was a positive association between the presence of myofascial pain and depressive symptoms (p=0,02), as the intensity of tinnitus increases and the severity of depressive symptoms (p<0,01). KEY WORDS:Tinnitus; Temporomandibular joint disorders; Depression; Quality of life. AVALIAÇÃO DA PRESENÇA DE SINTOMAS DEPRESSIVOS E QUALIDADE DE VIDA DE INDIVÍDUOS PORTADORES DE ZUMBIDO E DESORDENS TEMPOROMANDIBULARESRESUMO: Diversas etiologias são atribuídas ao desenvolvimento do zumbido subjetivo, contudo sua inter-relação com a presença das desordens temporomandibulares e depressão é ainda pouco compreendida. Avaliar a presença de sintomas depressivos em indivíduos portadores de DTM e zumbido subjetivo, avaliando o impacto da presença do zumbido na qualidade de vida dos mesmos. Elisa Lima AlvesAcademic at School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. Letícia Raquel BarakyAssociate Professor of Otorhinolaryngology, Federal University of Juiz de Fora -MG. PhD in Science from the University of São Paulo -USP, São Paulo, Brazil. Letícia Ladeira BonatoDoctoral student in Dentistry, School of Dentistry, Fluminense Federal University; Specialist in TMD and Orofacial Pain, Petrópolis School of Medicine, Petró-polis, Rio de Janeiro, Brazil. E-mail: leticialbonato@hotmail.com Luciano Ambrósio FerreiraDoctoral student in Sciences, School of Medicine, Federal University of Rio de Janeiro, Brazil. Ricardo Rodrigues FigueiredoDoctoral student in otorhinolaryngology UNIFESP; Master in General Surgery Otorhinolaryngology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Professor of Valencia Medical School, Rio de Janeiro, Brazil. Josemar Parreira Guimarães

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RESUMO:O desgaste dentário é considerado um processo fisiológico. Contudo, quando o mesmo apresenta-se acentuado, frequentemente o bruxismo é apontado como o único fator etiológico envolvido, desconsiderando-se outros possíveis padrões de desgaste, como a erosão e a abrasão. O propósito deste estudo foi avaliar através da análise da rugosidade superficial de dentes como é o padrão de desgaste dentário de mulheres diagnosticadas com erosão ácida e/ou atrição. Trata-se de um estudo descritivo observacional longitudinal. A amostra foi constituída por 20 mulheres entre 20 e 50 anos, divididas em grupo A (n=9), caracterizado por integrantes que realizavam o bruxismo, e grupo B (n=11), formado por mulheres que não realizavam tal função. Uma subdivisão foi ainda realizada, separando aquelas que possuíam fatores erosivos em sua dieta. Para obtenção das réplicas dentárias das pacientes, foi realizada moldagem da arcada superior com Silicona de Adição após minucioso exame clínico. Para análise da rugosidade superficial das amostras, foi utilizado o Rugosímetro Mitutoyo Surftest SJ-301. Todas as participantes do grupo A e B com fatores erosivos presentes apresentaram aumentos no parâmetro Ra, da ordem de 25,16%, 200% e 74,9%, respectivamente. O grupo B sem erosão foi o único em que a diferença observada não pode ser considerada significativa. Em relação à curva de material AbbotFirestone, a diferença apresentou-se acentuada apenas nos grupos onde havia a presença de fatores erosivos. Os resultados mostraram que o padrão de desgaste dentário quando presentes fatores erosivos é acentuado quando comparado com o desgaste decorrente apenas da atrição. PALAVRAS-CHAVE:Bruxismo; Desgaste Dentário; Erosão Dentária. PROFILE ANALYSIS OF STANDARD TEETH WEAR IN PEOPLE SUFFERING FROM BRUXISM AND ITS RELATIONSHIP WITH DENTAL EROSION: A LONGITUDINAL ANALYSISABSTRACT: Although teeth wear is a physiological process, bruxism or teeth grinding is indicated as the sole etiological factor involved, without taking into consideration other wear processes, such as erosion and abrasion. Current descriptive and longitudinal analysis evaluates the surface roughness in teeth as dental wear standard in females diagnosed with acid erosion or attrition. Sample comprised 20 females, aged between 20 and 50 years old, divided into Group A (n=9) characterized by teeth grinding, and Group B (n=11) without bruxism. A subdivision was also included by dividing those with erosion factors in the diet. After a thorough exam, molds of the upper teeth with Addition Silicon Impression were undertaken to obtain the patients´ dental replicas. Mitutoyo Surface Roughness Analyzer SJSaúde e Pesquisa, Maringá (PR)