When installing an immediate implant, you can choose between installing a temporary clinical crown, healing abutments, or to close the implant for a two-step surgical treatment. The use of customized healing abutments seals the implants and leads to individualized healing, which favors the creation of subsequent crowns. The present study aims to report a clinical case involving an immediate implant and the installation of customized healing abutments, demonstrating the results and the importance of knowledge of this technique by the dentist.

Quando feita a instalação de um implante imediato pode se optar entre a instalação de uma coroa provisória clínica, um cicatrizador ou pode se optar pelo fechamento do implante para um tratamento em duas etapas cirúrgicas. O uso de cicatrizadores personalizados sela os implantes e leva a uma cicatrização individualizada, que favorece a confecção das coroas subsequentes. O presente trabalho objetiva relatar um caso clínico envolvendo um implante imediato e a instalação de um cicatrizador personalizado, demonstrando os resultados e a importância de conhecimento dessa técnica pelo cirurgião-dentista.

RESUMO JUSTIFICATIVA E OBJETIVOS: O presente estudo visou comparar os índices de ansiedade, depressão e incapacidade em pacientes com dor miofascial, com e sem o diagnóstico adicional de enxaqueca. MÉTODOS: Foram incluídos 203 pacientes da Clínica de Dor Orofacial da Universidade da Califórnia, Los Angeles, EUA, com idade acima de 18 anos, ambos os sexos, com diagnóstico primário de dor miofascial. Os pacientes também foram avaliados quanto à presença de enxaqueca, segundo os critérios da Sociedade Internacional de Cefaleias. A amostra foi dividida em dois grupos: 120 pacientes com somente dor miofascial (Grupo 1), e 83 pacientes com dor miofascial e diagnóstico adicional de enxaqueca (Grupo 2). Foram aplicados os questionários: Inventário de Ansiedade de Beck, Inventário de Depressão de Beck e Migraine Disability Assessment Questionnaire. O teste de Mann-Whitney foi utilizado para comparar os grupos a um nível de significância de 5%. RESULTADOS: Os pacientes do grupo 1 apresentaram índices de Inventário de Ansiedade de Beck de p=0,005, Inventário de Depressão de Beck de p=0,025, e número de dias perdidos e/ou prejudicados (56,4 dias) significativamente maiores que os do grupo 2. Os escores Migraine Disability Assessment Questionnaire para os grupos 1 e 2 foram, respectivamente, para o grau I de 48% e 24,1%; grau II de 9,2% e 3,6%; grau III de 8,2% e 22,9%; e, grau IV de 34,7% e 49,4%. CONCLUSÃO: Os pacientes com dor miofascial e enxaqueca apresentaram índices de ansiedade, depressão e incapacidade significativamente maiores (p<0,05), além de níveis de incapacidade moderado e grave, consideravelmente superiores em relação ao grupo de pacientes com somente dor miofascial.

ABSTRACT BACKGROUND AND OBJECTIVES: The aim of this study was to compare anxiety, depression and disability indexes in patients with myofascial pain with and without additional diagnosis of migraine. METHODS: We included 203 patients of the Orofacial Pain Clinic of the University of California, Los Angeles, USA. Patients were over 18 years of age, both genders, with a primary diagnosis of myofascial pain. The patients were also evaluated for the presence of migraine according to the criteria of the International Headache Society. The sample was divided into two groups: 120 patients with only myofascial pain (Group 1) and 83 patients with myofascial pain and with an additional diagnosis of migraine (Group 2). The Beck Anxiety Inventory, Beck Depression Inventory and Migraine Disability Assessment questionnaires were applied. The Mann-Whitney test was used to compare the groups at a significance level of 5%. RESULTS: Patients in group 1 presented significantly higher indexes in the Beck Anxiety Inventory (p=0.005), Beck Depression Inventory (p=0.025) and number of days lost and/or impaired (56.4 days) than those in group 2. The Migraine Disability Assessment Questionnaire scores for groups 1 and 2 were, respectively, 48% and 24.1% for grade I; 9.2% and 3.6% for grade II; 8.2% and 22.9% for grade III; and, 34.7% and 49.4% for grade IV. CONCLUSION: Patients with myofascial pain and migraine had significantly higher anxiety, depression and disability indexes (p<0.05), as well as moderate and severe disability levels considerably higher than those with only myofascial pain.

OBJECTIVE: The purpose of this study was to compare the effectiveness of trigger points injections using lidocaine 0.5% and dry needling without any kind of home-based rehabilitation program. METHODS: Sixteen patients with myofascial pain and trigger points in masticatory muscles were randomly assigned to two groups and received only one application session. The pressure pain threshold (PPT) was recorded before and after the injection: Ten minutes, 24 hours later, 7, 15, 21 and 30 days after the treatment. Visual analogue scale (VAS) was used to in all evaluation periods. RESULTS: There were no difference between groups for PPT, but for all groups the PPT during the time significantly increased when compared the before treatment. VAS showed differences between groups and during the time. The 0.5% lidocaine had the lowest VAS values when compared to dry needling, but at 30 days there were no differences among them. CONCLUSIONS: Despite the differences in VAS and considering there were no differences in PPT increases, we concluded that, in this study, both groups were able to disrupt the mechanisms of trigger point and relieve the myofascial pain symptoms.

OBJETIVO: comparar a severidade da dor subjetiva e objetiva, além de outras características associadas entre pacientes com dor miofascial com e sem o diagnóstico adicional de enxaqueca. MÉTODOS: foram selecionados 203 pacientes, com idade média de 40,3 anos (89,2% do sexo feminino), que se apresentaram à Clínica de Dor Orofacial da Universidade da Califórnia, Los Angeles, EUA - todos com diagnóstico primário de dor miofascial. Pacientes com diagnóstico secundário de enxaqueca foram incluídos (n=83) e formaram o grupo 2. O teste de Mann-Whitney foi utilizado para comparar o grupo 1 (dor miofascial) com o 2 (dor miofascial + enxaqueca) quanto à intensidade de dor à palpação e subjetiva, através de Escalas Analógicas Visuais (EAV). Também com o auxílio de EAV, foram comparados estado de humor, problemas com a função, qualidade do sono e incapacidade. Em todos os testes foi adotado um nível de significância de 5%. RESULTADOS: o grupo 2 apresentou níveis de dor à palpação muscular estatisticamente maiores que o grupo 1 (p<0,05). Ao se analisar a intensidade de dor subjetiva obtida através da EAV, o grupo 2 apresentou níveis maiores de dor subjetiva (EAV) em todas as medições, com significância estatística para "dor no momento" e "dor máxima" (p<0,05). Da mesma maneira, o grupo 2 mostrou níveis maiores, obtidos através da EAV, de problemas com humor, incapacidade, problemas com a função mandibular e problemas com sono/descanso, sendo que apenas o último apresentou significância estatística (p<0,05). CONCLUSÕES: a comorbidade enxaqueca exerce forte impacto na severidade da dor e na qualidade de vida de pacientes que apresentam diagnóstico primário de dor miofascial.

OBJECTIVES: To compare subjective and objective pain intensity and associated characteristics in myofascial pain (MFP) patients with and without migraine. METHODS: The sample was comprised by 203 consecutive patients, mean age of 40.3 (89.2% of females), primarily diagnosed with MFP, who presented to the UCLA Orofacial Pain Clinic. Patients with secondary diagnosis of migraine (n=83) were included and comprised group 2. In order to compare group 1 (MFP) with group 2 (MFP + migraine) regarding objective pain (palpation scores) and subjective by means of visual analog scales (VAS) pain levels. Also, comparisons of mood problems, jaw function problems, sleep quality and disability levels using VAS were performed using the Mann-Whitney test. A significance level of 5% was adopted. RESULTS: Mann-Whitney test revealed that group 2 presented significantly higher pain levels on palpation of masticatory and cervical muscles in comparison to group 1 (p<0.05). Group 2 also presented higher levels of subjective pain, with statistical significance for "pain at the moment" and "highest pain" (p<0.05). Additionally, group 2 showed higher levels of mood problems, disability, jaw function impairment and sleep problems than group 1 with statistical significance for the later (p<0.05). CONCLUSIONS: Migraine comorbidity demonstrated a significant impact on pain intensity and life quality of patients with MFP. Clinicians should approach both conditions in order to achieve better treatment outcomes.

OBJECTIVES: To evaluate the effect of a chewing exercise on pain intensity and pressure-pain threshold in patients with myofascial pain. METHODS: Twenty-nine consecutive women diagnosed with myofascial pain (MFP) according to the Research Diagnostic Criteria comprised the experimental group and 15 healthy age-matched female were used as controls. Subjects were asked to chew a gum stick for 9 min and to stay at rest for another 9 min afterwards. Pain intensity was rated on a visual analog scale (VAS) every 3 min. At 0, 9 and 18 min, the pressure-pain threshold (PPT) was measured bilaterally on the masseter and the anterior, medium, and posterior temporalis muscles. RESULTS: Patients with myofascial pain reported increase (76%) and no change (24%) on the pain intensity measured with the VAS. A reduction of the PPT at all muscular sites after the exercise and a non-significant recovery after rest were also observed. CONCLUSION: The following conclusions can be drawn: 1. there are at least two subtypes of patients with myofascial pain that respond differently to experimental chewing; 2. the chewing protocol had an adequate discriminative ability in distinguishing patients with myofascial pain from healthy controls.