Prevalência de portadores de DTM em pacientes avaliados no setor de otorrinolaringologia Prevalence of patients harboring temporomandibular disorders in an otorhinolaryngology departament

A interação entre disfunção temporomandibular e otalgia é, mesmo nos dias atuais, motivo para especulações e hipóteses. Vários pesquisadores sugerem causas, conseqüências e supostos tratamentos. OBJETIVO: Verificar a prevalência de pacientes portadores de DTM em um serviço de otorrinolaringologia. TIPO DE ESTUDO: Este é um estudo epidemiológico do tipo descritivo com amostra transversal. MATERIAL E MÉTODO: Foram avaliados 221 pacientes do Serviço de Otorrinolaringologia do Hospital da Cidade, em Passo Fundo, Rio Grande do Sul, durante um período de dois meses. Para captação e interpretação dos dados, bem como verificação da disfunção temporomandibular, foi utilizado um questionário auto-aplicado previamente validado. RESULTADO: Após coleta e interpretação dos dados de 221 pacientes, os resultados obtidos foram: 48 pacientes (21.72%) considerados como necessitando de tratamento para DTM (índice de DTM moderada e severa), dos quais 35 pertenciam ao gênero feminino (72.9%) e 13 ao masculino (21.1%). Apenas 15 indivíduos do total (7.24%) estavam totalmente livres de sintomas de DTM. Quanto aos demais, apresentaram: dor de cabeça (33,5%), dor no pescoço e ombro (28,5%), dor na região do ouvido (29%) e ruídos articulares (25%). CONCLUSÃO: A prevalência de DTM foi de 21.72% sendo significantemente maior no gênero feminino (p: 0.0001); e as prevalências, em relação aos índices, foram: DTM ausente 37.56%; DTM leve 40.72%; DTM moderada 19%, e DTM severa 2.72%.<br>The interaction between Temporomandibular disorders (TMD) and otalgia is, even nowadays, a reason for speculation and hypotheses raising. Several researchers suggest causes, consequences and alleged treatments. STUDY DESIGN: This is an epidemiological, sectional cohort study of prevalence. AIM: The study demonstrates the prevalence of patients harboring TMDs in an otorhinolaryngology department. MATERIAL AND METHODOS: During a two-month period, 221 patients from the Otorhinolaryngology Department of the Hospital da Cidade de Passo Fundo, State of Rio Grande do Sul, Brazil were analyzed. A previously validated questionnaire was applied for data collection. RESULTS: In the present study, the need for dental assessment was observed in 48 patients ( 21.72%). In this group there were 35 female (72.9%) and 13 males (27.1%). Only 15 patients (7.24%) were entirely free of TMD symptoms. The remaining patients reported the following TMD symptoms: headaches: 34.39%, neck and shoulder pain: 28.50%, pain on the ear region: 30.32% and joint noises in 23.98%. CONCLUSION: The prevalence of Temporomandibular disorders was 21.72%, being significantly higher among female subjects (p:0.0001). The prevalence regarding the indexes, was: TMD absent: 37.56%; mild TMD: 40.72%; moderate TMD 19% and severe TMD: 2.72%

Dental ceramics and the molar crown testing ground

All ceramic crowns are highly esthetic restorations and their popularity has risen with the demand for life-like and cosmetic dentistry. Recent ceramic research has concentrated on developing a fundamental understanding of ceramic damage modes as influenced by microstructure. Dental investigations have elucidated three damage modes for ceramic layers in the 0.5-2 mm thickness using point contacts that duplicate tooth cuspal radii; classic Hertzian cone cracking, yield (pseudo-plastic behavior), and flexural cracking. Constitutive equations based upon materials properties have been developed that predict the damage modes operational for a given ceramic and thickness. Ceramic thickness or thickness of the stiff supporting core in layer crowns is critical in flexural cracking as well as the flaw state of the inner aspect of the crown. The elastic module of the supporting structure and of the luting cement and its thickness play a role in flexural fracture. Clinical studies of ceramics extending over 16 years are compared to the above relationships and predictions. Recommendations for clinical practice are made based upon the above