Resumo Introdução: A recuperação e manutenção de pacientes que sofrem de problemas cardíacos e respiratórios utilizando o Protocolo de Reabilitação Cardiopulmonar (PRCP) auxiliam na funcionalidade e no desenvolvimento das atividades de vida diárias (AVD) respeitando os limites fisiológicos. Objetivo: Verificar a eficácia de um PRCP em uma paciente com doença cardiorrespiratória, após cinco meses de treinamento. Métodos: Foi avaliado um paciente, gênero feminino, 66 anos, peso 78 Kg, altura 1,55 m, apresentando infarto agudo do miocárdio (IAM) e asma brônquica, submetido a avaliação da tolerância ao exercício pelo Teste de Caminhada de Seis Minutos (TC6), da flexibilidade da cadeia posterior e de membros inferiores (MMII) pelo Banco de Wells e avaliação da força de membros superiores (MMSS) pela dinamometria, com mensuração dos sinais vitais: pressão arterial (PA), frequência cardíaca (FC), frequência respiratória (FR), saturação periférica de oxigênio (SpO2), bem como dispnéia e cansaço de MMII avaliados pela Escala de Borg (EB-CR10), em repouso, durante e após a realização dos testes, pré e pós cinco meses do PRCP. Resultados: Verificou-se aumento de 145 metros no período do PRCP, ou seja, 30% da distância percorrida (DP) no TC6 (pré=345, pós=490 metros), na flexibilidade (pré=13, pós=19cm) observou-se um aumento de 32% e na força de MMSS observou-se para MSD (pré=26, pós=60 Kgf) e MSE (pré=28, pós=72 Kgf) um aumento de 57% e 61% respectivamente. Conclusão: Conclui-se que o PRCP no caso relatado mostrou-se eficaz no aumento da capacidade de exercício, força de MMSS e flexibilidade da cadeia posterior e de MMII.

Abstract Introduction: Recovery and maintenance of patients suffering from heart and respiratory diseases using the cardiopulmonary rehabilitation program (CPRP) help maintain their functionality and improve the activities of daily living (ADLs) carried out according to their functional limitations. Objective: To investigate the efficacy of a CPRP in a patient with cardiopulmonary disease, following a 5-month training program. Methods: A 66-year-old female patient, body weight 78 kg, height 1.55 m, diagnosed with acute myocardial infarction and bronchial asthma underwent a six-minute walk test (6MWT) to measure exercise tolerance; the Wells Bench was used to measure the flexibility of the posterior chain and lower limbs (LL), and a hand-held dynamometer (HHD) was used to measure upper limb strength (ULS).Vital sign measurements include blood pressure (BP), heart rate (HR), respiratory rate (RR), oxygen saturation (SpO2) as well as dyspnea and LL fatigue (modified Borg scale) at rest, during and after 5-month CPRP. Results: An increase of 145 meters during the cardiopulmonary rehabilitation program i.e. 30% of walk distance (WD) in the 6MWT (pre = 345, post = 490m). There was an increase of 32% in flexibility (pre = 13, post = 19cm); in right upper limb (pre = 26, post = 60 kgf) and left lower limb strength (pre = 28, post = 72kgf), there was an increase of 57% and 61%, respectively. Conclusion: The CPRP proved to be effective in increasing exercise capacity, upper limb strength and flexibility of the posterior chain and lower limbs.

Considering the biomechanical aspects, many facts need to be understood on the mandible, to know which effects unilateral occlusal changes may cause on the stomatognathic system. The aim of this study was to analyze the malocclusion by unilateral teeth extraction on the mandible morphology in gerbil. We used 10 gerbils Meriones unguiculatus, young male, weighing around 50-60g, divided into two groups (n=5), an experimental group and control, which evaluated the two hemi-mandibles, with a total of 20 samples which were measured by digital pachymeter. The measures were taken: (1) length and (2) width of the mandible condyle and (3) body height in the region of mandibular 1st molar. Data from these measurements were analyzed using ANOVA and Mann-Whitney test. The results of this study showed a statistically significant difference in the three measures between experimental and control groups. The width of the mandible head (condyle) showed statistical difference between the ipsilateral and contralateral sides to teeth extraction. It was concluded that the mastication modification by unilateral teeth extraction caused an imbalance, promoting not only a modification in the craniofacial growth pattern, but also a harmful effect on the stomatognathic system of the gerbil used as an experimental model in this study.

Considerando los aspectos biomecánicos, muchos hechos deben ser entendidos sobre la mandíbula, haciendo necesario comprender cuales son los efectos que pueden causar una alteración oclusal unilateral en el sistema estomatognático. El objetivo de este estudio fue analizar la maloclusión por la extracción de los dientes unilaterales sobre la morfología de la mandíbula en el gerbo. Se utilizaron 10 gerbos Meriones unguiculatus, machos jóvenes, con un peso aproximado de 50-60g, divididos en dos grupos (n = 5), un grupo experimental y otro control, en los cuales se evaluaron las dos hemimandíbulas, totalizando 20 muestras que fueron medidas con un caliper digital. Las medidas tomadas fueron: (1) longitud y (2) ancho del cóndilo mandibular, y (3) la altura del cuerpo en la región de los primeros molares mandibulares. Los datos de estas mediciones se analizaron mediante la prueba ANOVA y Mann-Whitney. Los resultados de este estudio mostraron una diferencia estadísticamente significativa en las tres medidas entre los grupos experimental y control. El ancho de la cabeza de la mandíbula (cóndilo) mostró una diferencia estadística entre los lados ipsilaterales y contralaterales a la extracción dentaria. Se concluyó que existe una alteración unilateral de la masticación inducida por la extracción de dientes unilateralmente, causando un desequilibrio y promoviendo no sólo una modificación en el patrón de crecimiento craneofacial, sino también un efecto nocivo obre el sistema estomatognático del gerbo utilizado como modelo experimental en este estudio.

A relação entre a amplitude do sinal eletromiográfico e a força muscular (EMG-força) tem sido tomada como medida indireta da força muscular. Este estudo, em 18 voluntárias saudáveis e destras, visou avaliar a influência da posição do braço na relação EMG-força em músculos do braço em três tarefas - flexão do braço (FB), abdução do braço (AB) e neutra do braço (NB) - enquanto se tomavam ambas as medidas: uma célula de carga foi acoplada ao conversor do eletromiógrafo para registrar simultaneamente força e sinal eletromiográfico. Foram analisados os sinais dos músculos bíceps braquial, braquiorradial e tríceps braquial, e estimada a força de flexão e de extensão do braço nas diferentes tarefas. A relação entre esses conjuntos de valores foi analisada estatisticamente, verificando se havia correlação entre força e sinal eletromiográfico. Os resultados mostraram não haver tal correlação nas tarefas avaliadas. A posição do braço não influenciou a relação EMG-força dos músculos avaliados, com exceção do tríceps braquial, cuja atividade eletromiográfica foi maior durante a tarefa NB. Conclui-se que, em isometria, as tarefas podem ser empregadas para ativar o bíceps braquial e o braquiorradial; a tarefa NB é a mais indicada para ativar o tríceps braquial.

The relationship between myoelectric signal amplitude and muscle strength (EMG-force) has been used as an indirect measure of muscle strength. The aim of this study, in 18 healthy, female, right-handed volunteers, was to assess the influence of arm position on the relationship EMG-force of arm muscles in three different tasks: arm flexion, arm abduction, and neutral arm position. Both myoelectric signals and strength measures were acquired simultaneously, by coupling a load-cell to the electromyograph transducer. Signals from the biceps brachii, braquioradialis, and triceps brachii muscles were analysed, and arm extension and flexion force was estimated. Relationships between these values were statistically analysed, searching for a correlation between myoelectric signal amplitude and muscle strength. Results showed no such correlation could be found during any of the tasks. Arm position did not influence EMG-force of the assessed muscles, to the exception of the triceps brachii muscle, which showed greater activity in the neutral arm task as compared to the other tasks. In isometric contractions, the tasks may be used to activate biceps brachii and braquioradialis; neutral arm position is indicated to activate the triceps brachii muscle.

Having broad knowledge of anatomy is essential for practicing dentistry. Certain anatomical structures call for detailed studies due to their anatomical and functional importance. Nevertheless, some structures are difficult to visualize and identify due to their small volume and complicated access. Such is the case of the parasympathetic ganglia located in the cranial part of the autonomic nervous system, which include: the ciliary ganglion (located deeply in the orbit, laterally to the optic nerve), the pterygopalatine ganglion (located in the pterygopalatine fossa), the submandibular ganglion (located laterally to the hyoglossus muscle, below the lingual nerve), and the otic ganglion (located medially to the mandibular nerve, right beneath the oval foramen). The aim of this study was to present these structures in dissected anatomic specimens and perform a comparative analysis regarding location and morphology. The proximity of the ganglia and associated nerves were also analyzed, as well as the number and volume of fibers connected to them. Human heads were dissected by planes, partially removing the adjacent structures to the point we could reach the parasympathetic ganglia. With this study, we concluded that there was no significant variation regarding the location of the studied ganglia. Morphologically, our observations concur with previous classical descriptions of the parasympathetic ganglia, but we observed variations regarding the proximity of the otic ganglion to the mandibular nerve. We also observed that there were variations regarding the number and volume of fiber bundles connected to the submandibular, otic, and pterygopalatine ganglia.

This study aimed to measure the active mandibular range of motion (ROM) (mouth opening: MO; right and left lateral movements: RL and LL; protrusion: P) in Brazilian children of both genders and of various ages, weights, and heights, and to establish correlations among such variables. Study subjects (n = 303) were healthy boys and girls, with ages ranging between 6 and 14 years, who were regular students of a public school in the state of São Paulo. Analysis of variance and intra-class correlation coefficients were considered significant for p < 0.05. Weak significant correlations were observed between mandibular ROM and age, height, and weight. No statistically significant differences (p > 0.05) were observed regarding mandibular ROM between gender groups. Mean mandibular ROM values showed significant increases (p < 0.05) in relation to age, height, and weight, except for RL (p > 0.05), in the studied age range. Significantly smaller (p < 0.05) mean mandibular ROM values were observed for the intervals of 6 and 7 years of age, 1.15-1.35 m, and 17.30-26.50 kg, in relation to the other ranges. Nonetheless, no differences were observed among mean mandibular ROM values in the ranges 8 to 12-14 years, 1.36-1.75 m, and 47-85 kg. Thus, it is suggested that weight, height, and age variables be considered when obtaining mandibular ROM values, particularly in children aged 6 to 7 years, measuring 1.15-1.35 m, and weighing between 17.3-46.5 kg.

The purpose of this study was to evaluate the newly formed bone, comparing two different carriers for rhBMP-2, using the decortication and nondecorticatication surgical technique in Wistar rat mandibles, evaluated by radiographic densitometry method. It was used fifty six animals according to specific treatment, which were sacrificed after 3 and 6 weeks after this. It was concluded that the decortication surgical technique was able to optimize the osteoinduction properties of the rhBMP-2, independently of the material carrier used and the period of time, according to radiographic densitometry technique.

El propósito de este estudio es evaluar la neoformación ósea con la densitometría radiográfica, comparando dos transportadores diferentes para el rhBMP-2, mediante la técnica quirúrgica con o sin la retirada previa de la cortical ósea, en mandíbulas de ratas Wistar. Fueron utilizados 56 animales, de acuerdo con el tratamiento específico, sacrificados después de 3 y 6 semanas. La densitometría radiográfica permitió concluir que la técnica quirúrgica de retirada de la cortical puede optimizar las características osteoinductoras del rhBMP-2, independientemente del transportador usado y del tiempo transcurrido.

Os sinais e sintomas de DTM podem contribuir na redução da força de mordida e da atividade muscular. O objetivo deste trabalho foi comparar a força de mordida em indivíduos com prótese total com DTM (Grupo CDTM) e sem DTM (Grupo SDTM). O Grupo CDTM (n=9) era composto por indivíduos que utilizavam as mesmas próteses totais há mais de 10 anos. O Grupo SDTM (n=9) por indivíduos com próteses totais satisfatórias quanto aos requisitos estruturais e funcionais, observados pelo profissional e relatados pelo paciente. O índice de Helkimo foi utilizado para análise do índice de disfunção. A força de mordida máxima foi medida na região de molares com gnatodinamômetro. Os resultados mostraram que o Grupo CDTM apresentou valor numérico médio de força de mordida menor que o Grupo SDTM, porém sem diferença estatisticamente significante entre os grupos avaliados (p<0,05) sugerindo que os sinais e sintomas da DTM e as condições estruturais das próteses não afetaram os resultados da força de mordida.

The signs and symptoms of temporomandibular dysfunction (TMD) may contribute to reduce bite force and muscular activity. The aims of this study were to compare bite force in complete denture wearers with TMD (TMD group) and without TMD (healthy group).The TMD group consisted of 9 individuals, who had worn a maxillary and a mandibular complete removable denture for more than 10 years. The healthy group consisted of 9 participants who wore dentures and had satisfactory interocclusal and maxillomandibular relationship. Helkimo Index was used to analyze the dysfunction level. Maximum bite force was measured using a digital dynamometer with capacity of 100 kgf and adapted to oral conditions.The TMD group presented smaller mean bite force values than the healthy group, though without statistical significance (p>0.05). This outcome suggests that the TMD signs and symptoms and the structural conditions of the dentures did not affect the maximal bite force of complete denture wearers.

In addition to an initial socket discomfort, ocular prosthesis (OP) installation may allow the adherence of fungi and/or bacteria due to the superficial characteristics of the prosthesis' material, use of inadequate cleansing solutions and methods, or because the void located between the internal portion of the prosthesis and the anophthalmic cavity (AC) mucosa. Objective: The aim of this study was to evaluate OP biofilm formation and the level of contamination of the internal portion of the OP and the AC in 24 patients. Material and Methods: Material was collected from the AC at the beginning of the study and 15 days after cleansing of the OP with 3 cleansing solutions: a neutral liquid soap, a multiuse solution for contact lens (Complete) and 0.12% chlorhexidine (Periogard). The collected materials were sowed in Petri dishes containing selective media for aerobic and facultative microorganisms, specifically staphylococci (Hipersalt agar with egg yolk), aerobic microorganisms (Brain Heart Infusion Blood Agar), streptococci (Mitis salivarius Agar), gram-negative bacilli (MacConkey Agar) and yeasts (Chromagar CandidaTM), incubated at 35ºC or 37ºC and the number of colony forming units were counted. Data were analyzed statistically by ANOVA, Friedman's test and Spearman's correlation. Results: Aerobic microorganisms, gram-negative bacilli and S. aureus were found in the OP biofilm and in the AC. There was statistically significant difference (p<0.05) between the number of microorganisms before and after the use of the cleansing solutions. Conclusion: There was positive correlation with respect to the microorganisms present in the OP biofilm and AC for the 4 proposed treatments, indicating that the decrease of OP contamination leads to AC contamination as well.

A eletromiografia, como método de estudo, tem sido bastante utilizada e vem contribuindo para elucidar o desempenho da musculatura peribucal em vários processos fisiológicos como a mastigação, deglutição e fala, e é um instrumento importante na análise das bases fisiopatológicas das mudanças que ocorrem nesta musculatura. Muitos trabalhos têm sido conduzidos em pacientes com deficiência auditiva e de fala, mas nenhum deles avaliou a musculatura responsável pela fala. Este estudo comparou medidas eletromiográficas dos fascículos superior e inferior do músculo orbicular da boca em indivíduos portadores de deficiência auditiva neurossensorial profunda (surdos) com indivíduos clinicamente normais (ouvintes). A análise eletromiográfica foi realizada em 20 indivíduos, de ambos os sexos, com idade média de 18,5 anos, divididos em dois grupos: o primeiro grupo constituído por 10 indivíduos portadores de deficiência auditiva neurossensorial profunda bilateral e o segundo por indivíduos clinicamente normais. Cinco condições clínicas foram avaliadas: sucção, sopro, projeção e compressão labial e emissão da sílaba "Pa". Verificou-se que os pacientes surdos apresentaram hiperatividade muscular em todas as condições clínicas analisadas, e que o fascículo inferior do músculo orbicular da boca apresentou os níveis mais altos de atividade eletromiográfica, sugerindo a necessidade de um tratamento fonoaudiológico, com enfoque em motricidade oral.

Electromyography has been used to evaluate the performance of the peribuccal musculature in mastication, swallowing and speech, and is an important tool for analysis of physiopathological changes affecting this musculature. Many investigations have been conducted in patients with auditory and speech deficiencies, but none has evaluated the musculature responsible for the speech. This study compared the electromyographic measurements of the superior and inferior fascicles of the orbicularis oris muscle in patients with profound bilateral neurosensorial hearing deficiency (deafness) and healthy volunteers. Electromyographic analysis was performed on recordings from 20 volunteers (mean age of 18.5 years) matched for gender and age. Subjects were assigned to two groups, as follows: a group formed by 10 individuals with profound bilateral neurosensorial hearing deficiency (deaf individuals) and a second group formed by 10 healthy individuals (hearers). Five clinical conditions were evaluated: suction, blowing, lip projection and compression, and production of the syllable "Pa". It was found that the deaf patients presented muscle hyperactivity in all clinical conditions, and that the inferior fascicle of the orbicularis oris muscle showed higher electromyographic activity rates, suggesting the need for a hearing-speech treatment with emphasis on oral motricity.

O objetivo deste trabalho é de apresentar um material didático que permita ao aluno de odontologia, identificar com maior facilidade, as características morfológicas dos dentes permanentes assim como entender mais facilmente a oclusão dos dentes. Para isto, foram confeccionados macromodelos de dentes permanentes sem desgaste, que foram obtidos da seguinte maneira: foram esculpidos macromodelos em cera; posteriormente estes foram moldados com alginato e os moldes foram preenchidos com gesso pedra e resina acrílica. Os macromodelos de gesso pedra foram montados em oclusão em uma base de cera #7 sendo obtidas desta maneira as arcadas superior e inferior. Estas arcadas montadas em cera foram moldadas novamente e o molde foi preenchido com gesso pedra, obtendo então as duas arcadas totalmente em gesso. Os autores concluíram que os macromodelos permitem uma melhor visualização das características morfológicas dos dentes permanentes bem como da oclusão; os alunos conseguem esculpir dentes permanentes em cera, com maior facilidade, quando observam macromodelos.

The purpose of this report is to present educational material that would allow the dental student to learn to easily identify the morphologic characteristics of permanent teeth, and how they fit together (occlusion). In order to do this, macro models of permanent teeth with no attrition were carved in wax and later molded with alginate. These molds were filled with plaster, dental stone and/or cold-cured acrylic resin. The large individual dental stone tooth models were mounted on a wax base, thus obtaining maxillary and mandibular arches which were occluded. These dental arches were molded with plaster or dental stone. The authors suggest that these types of macro models allow an excellent visualization of the morphologic characteristics of permanent teeth and occlusion. Dental students are able to carve the permanent dentition in wax with great facility when they can observe macro models.