OBJETIVO: O estudo teve como finalidade avaliar a utilização de dois índices (Helkimo e craniomandibular) para o diagnóstico da desordem temporomandibular (DTM) em pacientes com Artrite Reumatóide (AR). MATERIAIS E MÉTODOS: A amostra foi de 80 pacientes divididos em dois grupos: pacientes com AR e pacientes sem AR. Em ambos os grupos os dois índices foram utilizados. No diagnóstico da DTM foram avaliados os seguintes sinais e sintomas: dor na ATM; limitação de abertura de boca e ruídos articulares. RESULTADOS: Os resultados mostram que dos pacientes com AR 87,1% eram do gênero feminino e 12,9% do masculino. Entre os pacientes sem AR, 70% eram do gênero feminino e 30% do masculino. A idade dos pacientes com AR variou de 24 a 78 anos. Entre os pacientes sem AR, a idade variou de 22 a 72 anos. Foi verificado que a prevalência de DTM foi mais elevada no grupo de pacientes com AR (98,6% - Helkimo e 87,1% - craniomandibular) do que no grupo sem a doença (80% - Helkimo e 50% - craniomandibular). CONCLUSÃO: Em resumo, temos que ambos os índices são capazes de diagnosticar a desordem temporomandibular em pacientes com AR, entretanto o Índice de Helkimo é menos preciso.
Objective: The objective of this research was to review the literature, compare different methods of surgical treatment for coronoid hyperplasia and report a clinical case of unilateral coronoid hyperplasia treated by coronoidectomy with intraoral access. Methods: A critical review of the literature was performed by selection of papers published in the last 20 years on the treatment of coronoid in adults in the PubMed, Medline, Scielo and Lilacs databases, with the terms coronoid hyperplasia OR coronoid elongation AND treatment OR management. The data was extracted for analysis. Results: twenty-four articles were selected. It included 42 patients, among them 69% were male patients and 81% were bilaterally affected. The age group with the highest prevalence was the people in the 20's and 30's. Sixty-nine percent of the patients were treated with coronoidectomy and 26.2% with coronoidotomy. The majority (83.3%) with intraoral access. No cases had surgical complications reported, and 71.4% underwent physiotherapy after surgery. Regarding the results, 83.3% were considered satisfactory, 11.9% were unsatisfactory. Conclusion: The great majority of the cases that brought significant results in the improvement of the pre and postoperative mouth opening were treated by coronoidectomy, proving to be an efficient and safe surgical treatment for the coronoid hyperplasia.
The aim of the present overview was to evaluate the outcomes of systematic reviews to determine the incidence of condylar resorption in patients submitted to orthognathic surgery and analyze whether the risk of developing this condition is related to a specific type of surgery. Searches were conducted in the PubMed/MEDLINE, Embase, and Cochrane electronic databases for systematic reviews with quantitative data on condylar resorption due to any type of orthognathic surgery for dentoskeletal deformities published up to May 25, 2019. The AMSTAR 2 and Glenny tools were applied for the quality appraisal. Five systematic reviews were included for analysis. Only one article was considered to have high quality. Among a total of 5128 patients, 12.32% developed condylar resorption. From those patients, 70.1% had double jaw surgery, 23.4% had mandibular surgery alone, and in 6.5% a Lefort I technique was used. Based on these findings, bimaxillary surgery could be considered a risk factor for condylar resorption. However, these results should be interpreted with caution, since other factors, such as preoperative skeletal deformities, type of movement, and type of fixation, can contribute to the development of this condition. Further studies should consider reporting main cephalometric data, temporomandibular diagnosis, hormonal levels, and tomographic measures before and after the surgery at least every 6 months during the firsts two years to identify accurately risk factors for condylar resorption.
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