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Objective The study aims to demonstrate an evaluation method to predict the functional success of total wrist arthrodesis (TWA) and assist its indication. Methods A prospective study including ten patients submitted to (TWA) posttraumatic arthritis. Exclusion criteria were patients who lost postoperative follow-up or incomplete information in the medical record. The objective functional assessment (handgrip strength, three-point pinch, lateral pinch and pulp-pulp pinch) and the subjective functional assessment (DASH, PRWE, EVA) were evaluated in 3 different periods: (1) Before surgery without articular anesthesia, (2) Before surgery under articular anesthesia and (3) 12 weeks after the surgical procedure. Results There was an increase in handgrip strength in all three pinches measurements after pain relief, both after joint anesthesia and after the consolidation of the arthrodesis (p < 0.05). In the comparisons between the subjective evaluations (DASH, PRWE and VAS), the patients had better scores in the postoperative evaluation after 12 weeks (p < 0.05). There was no statistical difference when comparing the mean strength values found after anesthesia and after 12 weeks of TWA. Conclusion the outcomes could propose an assessment protocol for patients with indication for TWA, in which patients with good response to intra-articular anesthetic infiltration would benefit from the effects of the surgical procedure.

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Objective To evaluate the open surgical treatment for carpal tunnel syndrome as a risk factor for the development of stenosing tenosynovitis that results in trigger finger and De Quervain disease. Materials and Methods A retrospective study analyzing the medical records of patients submitted to open surgical release of carpal tunnel syndrome between 2010 and 2021 in a secondary- and tertiary-level hospital. The following data were collected: pathological history, duration of the follow-up after the surgical treatment for carpal tunnel syndrome, development of trigger finger or De Quervain tenosynovitis, affected fingers, and the interval between the end of surgery and symptom onset. Results We evaluated 802 patients of both genders and with a mean age of 50.1 (±12.6) years. The mean follow-up was of 13 (±16.4) months. The mean time until the development of trigger finger was of 61.4 months, and of 73.7 months for De Quervain disease. The incidence of development of De Quervain disease was of 4.12%, and for trigger finger it was of 10.2%. The most affected digits were the thumb (47.6%), the middle (24.4%), and the ring finger (8.54%). Age was the only factor that showed an association with the risk of developing trigger finger, with an increase of 2% for each increase in age of 1 year. Conclusion The incidence rates for the development of De Quervain disease (4.12%) and trigger finger (10.2%) after the surgical treatment for carpal tunnel syndrome were like those described in the literature. Only age was a factor that influenced the development of trigger finger.

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Abstract Objective The study aims to demonstrate an evaluation method to predict the functional success of total wrist arthrodesis (TWA) and assist its indication. Methods A prospective study including ten patients submitted to (TWA) posttraumatic arthritis. Exclusion criteria were patients who lost postoperative follow-up or incomplete information in the medical record. The objective functional assessment (handgrip strength, three-point pinch, lateral pinch and pulp-pulp pinch) and the subjective functional assessment (DASH, PRWE, EVA) were evaluated in 3 different periods: (1) Before surgery without articular anesthesia, (2) Before surgery under articular anesthesia and (3) 12 weeks after the surgical procedure. Results There was an increase in handgrip strength in all three pinches measurements after pain relief, both after joint anesthesia and after the consolidation of the arthrodesis (p < 0.05). In the comparisons between the subjective evaluations (DASH, PRWE and VAS), the patients had better scores in the postoperative evaluation after 12 weeks (p < 0.05). There was no statistical difference when comparing the mean strength values found after anesthesia and after 12 weeks of TWA. Conclusion the outcomes could propose an assessment protocol for patients with indication for TWA, in which patients with good response to intra-articular anesthetic infiltration would benefit from the effects of the surgical procedure.

Resumo Objetivo O estudo tem como objetivo demonstrar um método de avaliação para predizer o sucesso funcional da artrodese total do punho (ATP) e auxiliar na sua indicação. Métodos Um estudo prospectivo incluindo dez pacientes submetidos a ATP por artrite pós-traumática. Os critérios de exclusão foram pacientes que perderam o acompanhamento pós-operatório ou informações incompletas no prontuário. A avaliação funcional objetiva (força de preensão manual, pinça de três pontos, pinça lateral e pinça polpa-a-polpa) e a avaliação funcional subjetiva (DASH, PRWE, EVA) foram avaliadas em 3 momentos diferentes: (1) Antes da cirurgia sem anestesia articular, (2) Antes da cirurgia sob anestesia articular e (3) 12 semanas após o procedimento cirúrgico. Resultados Houve aumento da força de preensão palmar nas três medidas de pinça após o alívio da dor, tanto após a anestesia articular quanto após a consolidação da artrodese (p < 0,05). Nas comparações entre as avaliações subjetivas (DASH, PRWE e VAS), os pacientes tiveram melhores escores na avaliação pós-operatória após 12 semanas (p < 0,05). Não houve diferença estatística ao comparar os valores médios de força encontrados após a anestesia e após 12 semanas de ATP.

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Abstract Objective To evaluate the open surgical treatment for carpal tunnel syndrome as a risk factor for the development of stenosing tenosynovitis that results in trigger finger and De Quervain disease. Materials and Methods A retrospective study analyzing the medical records of patients submitted to open surgical release of carpal tunnel syndrome between 2010 and 2021 in a secondary- and tertiary-level hospital. The following data were collected: pathological history, duration of the follow-up after the surgical treatment for carpal tunnel syndrome, development of trigger finger or De Quervain tenosynovitis, affected fingers, and the interval between the end of surgery and symptom onset. Results We evaluated 802 patients of both genders and with a mean age of 50.1 (±12.6) years. The mean follow-up was of 13 (±16.4) months. The mean time until the development of trigger finger was of 61.4 months, and of 73.7 months for De Quervain disease. The incidence of development of De Quervain disease was of 4.12%, and for trigger finger it was of 10.2%. The most affected digits were the thumb (47.6%), the middle (24.4%), and the ring finger (8.54%). Age was the only factor that showed an association with the risk of developing trigger finger, with an increase of 2% for each increase in age of 1 year. Conclusion The incidence rates for the development of De Quervain disease (4.12%) and trigger finger (10.2%) after the surgical treatment for carpal tunnel syndrome were like those described in the literature. Only age was a factor that influenced the development of trigger finger.

Resumo Objetivo Avaliar o tratamento cirúrgico aberto da síndrome do túnel do carpo como fator de risco para o desenvolvimento das tenossinovites estenosantes formadoras do dedo em gatilho e da doença de De Quervain. Materiais e Métodos Estudo retrospectivo com análise dos prontuários de pacientes submetidos a liberação cirúrgica aberta da síndrome do túnel do carpo entre 2010 e 2021 em hospital de níveis secundário e terciário. Os seguintes dados foram coletados: histórico patológico, tempo de acompanhamento após o tratamento cirúrgico da síndrome do túnel do carpo, desenvolvimento de dedo em gatilho ou tenossinovite de De Quervain, dedos acometidos, e tempo decorrido entre o fim da cirurgia e o aparecimento dos sintomas. Resultados Foram avaliados 802 pacientes de ambos os sexos com média de idade de 50,1 (±12,6) anos. O tempo médio de seguimento foi de 13 (±16,4) meses. O tempo médio de desenvolvimento de dedo em gatilho foi de 61,4 meses, e o da doença de De Quervain, de 73,7 meses. A incidência de desenvolvimento da doença de De Quervain foi de 4,12% e a de dedo em gatilho, de 10,2%. Os dedos mais acometidos foram o polegar (47,6%), o médio (24,4%) e o anular (8,54%). A idade foi único fator que demonstrou associação com o risco de desenvolvimento de dedo em gatilho, com aumento de 2% a cada ano a mais de idade. Conclusão As taxas de incidência de desenvolvimento de doença de De Quervain (4,12%) e de dedo em gatilho (10,2%) após tratamento cirúrgico da síndrome do túnel do carpo foram semelhantes às descritas na literatura. Apenas a idade se apresentou como fator influenciador no desenvolvimento de dedo em gatilho.

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Objective To evaluate the use of external fixators in the delta-type kickstand configuration as an adjuvant method in the postoperative period of patients submitted to free flaps in the lower limbs. Methods A total of 17 external delta fixators were used in patients submitted to free flaps in the lower limbs. The surgical technique was performed in a standardized manner, with the distal pin located 6 cm proximally to the anastomosis, and the proximal pin, 6 cm distally to the anterior tuberosity of the tibia. Results The mean age of the sample was of 34.76 years (range: 15 to 66 years). In total, 11 men and 6 women were selected. The posterior tibial artery was used in 14 cases, and the anterior tibial artery, in 3 cases. The mean time of use of the external fixators was of 3.88 weeks. The rate of reoperation was of 17.64%; that of retail loss was of 11.76%; that of success rate was of 88.23%; and the rate of infection was of 5.9%. Conclusion The use of delta-type fixators as an adjunct method in the postoperative period is reliable; however, more studies are needed to evaluate its true role in the postoperative period.

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Abstract Objective To evaluate the use of external fixators in the delta-type kickstand configuration as an adjuvant method in the postoperative period of patients submitted to free flaps in the lower limbs. Methods A total of 17 external delta fixators were used in patients submitted to free flaps in the lower limbs. The surgical technique was performed in a standardized manner, with the distal pin located 6 cm proximally to the anastomosis, and the proximal pin, 6 cm distally to the anterior tuberosity of the tibia. Results The mean age of the sample was of 34.76 years (range: 15 to 66 years). In total, 11 men and 6 women were selected. The posterior tibial artery was used in 14 cases, and the anterior tibial artery, in 3 cases. The mean time of use of the external fixators was of 3.88 weeks. The rate of reoperation was of 17.64%; that of retail loss was of 11.76%; that of success rate was of 88.23%; and the rate of infection was of 5.9%. Conclusion The use of delta-type fixators as an adjunct method in the postoperative period is reliable; however, more studies are needed to evaluate its true role in the postoperative period.

Resumo Objetivo Avaliar o uso de fixadores externos, na configuração kickstand do tipo delta, como método adjuvante no período pós-operatório de pacientes submetidos a retalhos livres nos membros inferiores. Métodos Ao todo, 17 fixadores externos do tipo delta foram utilizados em pacientes submetidos a retalhos livres nos membros inferiores. A técnica cirúrgica foi realizada de forma padronizada, com o pino distal localizado 6 cm proximal à anastomose, e o pino proximal, 6cm distal à tuberosidade anterior da tíbia. Resultados A idade média da amostra foi de 34,76 anos (variação: 15 a 66 anos). Foram selecionados 11 homens e 6 mulheres. Utilizou-se a artéria tibial posterior em 14 casos, e a tibial anterior, em 3 casos. O tempo médio de uso dos fixadores externos foi de 3,88 semanas. A taxa de reoperação foi de 17,64%; a de perda do retalho foi de 11,76%; a de sucesso foi de 88,23%; e a taxa de infecção foi de 5,9%. Conclusão O uso de fixadores do tipo delta como método adjuvante no pós-operatório é confiável; porém, mais estudos são necessários para avaliar seu verdadeiro papel no pós-operatório.

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Objectives The aim of the present article is a clinical and radiographic evaluation of scaphoid nonunion with humpback deformity using an iliac graft and a volar plate. Methods Eight patients were followed-up prospectively, all male, with a mean age of 39.6 years old, with scaphoid waist nonunion, with an average of 19 months of trauma without previous surgery. The patients were treated with a graft removed from the iliac crest and a 1.5 mm blocked volar scaphoid plate (Medarthis AG, Basel, Switzerland). The patients were followed-up with radiographic evaluations and computed tomography (CT) scans in the preoperative period and 1 month, 3 months, 6 months and 1 year after the operation. The carpal height and the scaphosemilunar and intrascaphoid angles were measured preoperatively, 3 months, and 1 year postoperatively. The function was assessed preoperatively and repeated 1 year postoperatively using the Disabilities of the Arm, Shoulder, and Hand (DASH) and Patient-related Wrist Evaluation (PWRE scores), as well as by measurement of forceps clamp and wrist and thumb range of motion. Results All cases were consolidated, with an average time of 3.38 months. Two complications were observed: an infection of the iliac surgical wound and a plaque element placed in the scapholunate space. Two patients opted to remove the implant because they had a painful click at maximum wrist flexion. There was improvement in the parameters of wrist and thumb range of motion and pinch strength in all measurements, with statistical significance for the PRWE and the scapholunate angle. Conclusion Although our sample was small, we achieved consolidation in all cases; the complications were expected in the literature and there were improvements in the radiographic patterns, in the functional assessment, and in the pain scale of our patients.

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Background: Fractures of the proximal humerus are challenging injuries. They have a functional impairment and can be managed by non-operative or operative methods. Surgical methods can be intramedullary nails, tension-band wiring, or plates and screws. Aim of the study: This study aims to show the outcomes of managing fractures of the proximal humerus using the trefoil plate method. Methods: Eight young patients with type 2 or 3 part proximal humerus fractures were retrospectively analyzed concerning the cloverleaf plate fixation and consolidation method. Patients with 4-part fractures were excluded. Results: We obtained 100% consolidation with a mean ROM of 109 degrees for abduction, 4.4 degrees for external rotation, and good internal rotation. Conclusion: the trefoil plate osteosynthesis method can be used in young patients with 2-or 3-part fractures of the proximal humerus(AU)

Introdução: As fraturas do úmero proximal são lesões desafiadoras. Associam-se a deficiência funcional e podem ser gerenciadas por métodos não operatórios ou operatórios. Os métodos cirúrgicos podem ser hastes intramedulares, fiação de banda de tensão ou placas e parafusos. Objetivo do estudo: Este estudo visa mostrar os resultados do tratamento das fraturas do úmero proximal pelo método da placa trifólio. Métodos: Oito pacientes jovens com fratura proximal do úmero do tipo 2 ou 3 partes foram analisados retrospectivamente quanto à fixação da placa de trevo e método de consolidação. Pacientes com fraturas em 4 partes foram excluídos. Resultados: Obtivemos 100% de consolidação com ADM média de 109graus para abdução, 4,4 graus para rotação externa e boa rotação interna. Conclusão: o método de osteossíntese de placa trifólio pode ser utilizado em pacientes jovens com fratura em 2 ou 3 partes do úmero proximal(AU)

Antecedentes: las fracturas del húmero proximal son lesiones desafiantes. Tienen un deterioro funcional y pueden ser manejados por métodos quirúrgicos o no quirúrgicos. Los métodos quirúrgicos pueden ser clavos intramedulares, alambres con bandas de tensión o placas y tornillos. Objetivo del estudio: Este estudio tiene como objetivo mostrar los resultados del tratamiento de las fracturas del húmero proximal mediante el método de la placa de trébol. Métodos: Se analizaron retrospectivamente ocho pacientes jóvenes con fracturas de húmero proximal de tipo 2 o 3 en relación con el método de fijación y consolidación con placa entrébol. Se excluyeron los pacientes con fracturas en 4 partes. Resultados: Obtuvimos una consolidación del 100% con un ROM medio de 109 grados para abducción, 4,4 grados para rotación externa y buena rotación interna. Conclusión: el método de osteosíntesis con placa de trébol se puede utilizar en pacientes jóvenes con fracturas en 2o 3 partes del húmero proximal(AU)

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Objectives The present study aimed to evaluate the diagnostic failure rate in detecting perilunate fractures and dislocations using plain wrist radiographs by orthopedists and orthopedic residents. A secondary objective was to identify possible groups with a greater or lesser chance of establishing a correct diagnosis. Methods An online questionnaire was sent to several orthopedists through e-mail, social networks, and smartphone-based communication applications to assess the rate of diagnostic failure in detecting perilunate fractures and dislocations using plain radiographs. Results A total of 511 responses was obtained, with a diagnostic error rate of 8.81% for simple dislocations and 1.76% for trans-scaphoid perilunate fractures. Group stratification showed that residents presented the highest error rates in simple perilunate dislocations (23.91%), whereas hand surgeons presented the lowest error rates (1.74%). Conclusion Compared with the literature, the failure rates found were lower, suggesting that plain radiography is effective and that the error rate may not be as high as reported.

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BACKGROUND: Among the alternatives for the management of malignant bone tumors is the "devitalized autograft associated with vascularized fibula graft." The devitalization process is achieved by pasteurization, irradiation, or freezing. The combination of these grafts has been broadly researched for more than 25 years. However, there is no research currently published comparing the various methods or their respective outcomes. METHODS: A retrospective study was compiled of 26 devitalized autografts associated with vascularized fibula performed to limb salvage of malignant bone tumors. They were divided into two groups according to the devitalization method: either freezing (12 procedures) or irradiation (14 procedures). Clinical, radiographic, and scintigraphic results were assessed at least 24 months after surgery. RESULTS: The union rates reached 83.3% in the freezing group and 92.8% in the irradiated group but did not express different outcomes. Scintigraphic viability was observed in all the grafts that achieved radiographic union (Mann-Whitney U-test: p = 0.005). Three patients had nonunion, with only one having no viability in the scintigraphy (Mann-Whitney U-test: p = 0.001). There was no malignant recurrence in the autograft, only in surrounding soft tissues. Local recurrence was statistically higher in larger tumors (Mann-Whitney U-test: p = 0.025). CONCLUSION: Both groups presented similar union rates and are considered safe to devitalize bone graft despite different outcomes observed. The survivor rates observed could be limited by the existence of the techniques.

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Introdução: A tenossinovite estenosante de De Quervain, doença inflamatória mais comum do punho, de maior prevalência no sexo feminino e na faixa etária de 30 a 50 anos, caracteriza-se pelo envolvimento da bainha sinovial do primeiro compartimento extensor do punho, que inclui os tendões abdutor longo do polegar (ALP) e extensor curto do polegar (ECP). Apesar da etiologia indefinida, atribui-se caráter multifatorial como traumas, sobrecarga de exercícios repetitivos com punho e mão, alterações metabólicas, reumáticas e variações anatômicas, como a presença de dois ou mais tendões do ALP e ECP e septo no túnel osteofibroso. Dentre as alternativas terapêuticas encontra-se a infiltração com corticosteroides. Material e Método: Foi avaliado o resultado terapêutico em 15 pacientes submetidos à infiltração local de corticosteroide através dos questionários DASH, PRWE e Escala Visual da Dor. Resultados: observou-se melhora significativa dos pacientes avaliados. Conclusão: o tratamento com corticosteroides é eficaz e seguro(AU)

Introduction: Quervain's tenosynovitis, the most common inflammatory wrist disease, most prevalent in females and in the age group of 30 to 50 years, is characterized by the involvement of the synovial sheath of the first extensor compartment of the wrist, which includes the thumb long abductor tendons (ALP) and short thumb extensor (ECP) tendons. Despite the undefined etiology, multifactorial character is attributed as trauma, overload of repetitive exercises with wrist and hand, metabolic, rheumatic alterations and anatomical variations, such as the presence of two or more ALP and ECP tendons and osteofibrosal tunnel septum. Among the therapeutic alternatives is infiltration with corticosteroids. Material and Method: The therapeutic outcome was evaluated in 15 patients who underwent local corticosteroid infiltration using the DASH and PRWE questionnaires and Visual Analogue Scale. Results: Significant improvement was observed in the evaluated patients. Conclusion: Corticosteroid treatment is effective and safe(AU)

Introducción: la tenosinovitis de De Quervain, la enfermedad inflamatoria de la muñeca más común, más prevalente en mujeres y en el grupo de edad de 30 a 50 años, se caracteriza por la afectación de la vaina sinovial del primer compartimento extensor de la muñeca, que incluye el tendones abductores largos del pulgar (ALP) y tendones extensores del pulgar cortos (ECP). A pesar de la etiología indefinida, el carácter multifactorial se atribuye a trauma, sobrecarga de ejercicios repetitivos con muñeca y mano, alteraciones metabólicas, reumáticas y variaciones anatómicas, como la presencia de dos o más tendones ALP y ECP y tabique osteofibrosal. Entre las alternativas terapéuticas se encuentra la infiltración con corticosteroides. Material y método: El resultado terapéutico se evaluó en 15 pacientes que se sometieron a infiltración local de corticosteroides utilizando los cuestionarios DASH y PRWE y escala visual analógica del dolor. Resultados: se observó una mejoría significativa en los pacientes evaluados. Conclusión: el tratamiento con corticosteroides es efectivo y seguro(AU)

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Introdução: As lesões do tendão musculo subescapular (TMSE) do manguito rotador passaram a ter aumento de sua incidência com as avançadas técnicas de diagnostico por imagem e artroscópicas. A Ressonância Nuclear Magnética (RM) apresenta boa sensibilidade e especificidade permitindo adequada acurácia diagnóstico. Objetivo: avaliação da concordância interobservador da RM para Lesões do TMSE comparada à artroscopia. Métodologia: 49 pacientes sintomáticos foram submetidos à RM para diagnóstico de lesão do TMSE e avaliação da Classificação de Lafosse, tendo sua concordância avaliada através da Artroscopia diagnostica. Resultados: A acurácia global foi 68% para concordância diagnóstica da Lesão do TMSE e 57,1% para concordância na classificação de Lafosse. Discussão: obteve-se concordância para o diagnóstico de Lesão ou ausência de Lesão do TMSE de 0,49 e a concordância para a Classificação de Lafosse foi de 0,30. Conclusão: o diagnóstico da lesão do TMSE através da RM é de difícil realização(AU)

Introduction: Injuries of subscapular muscle tendon (SEMT) of the rotator cuff have been increased in incidence with advanced imaging and arthroscopic techniques. Magnetic Nuclear Resonance (MRI) presents good sensitivity and specificity allowing adequate diagnostic accuracy. Objective: to evaluate the interobserver agreement of MRI for SEMT lesions compared to arthroscopy. Methods: 49 symptomatic patients underwent MRI for diagnosis of SEMT lesion and evaluation of the Lafosse Classification, and their concordance was assessed through diagnostic arthroscopy. Results: The overall accuracy was 68% for diagnostic concordance of the SEMT Lesion and 57.1% for concordance in the Lafosse classification. Discussion: concordance was obtained for the diagnosis of Lesion or absence of Lesion of the SEMT of 0.49 and the agreement for the Lafosse Classification was 0.30. Conclusion: the diagnosis of SEMT lesion through MRI is difficult to perform(AU)

Introducción: Las lesiones del tendón musculo subescapular (TMSE) del manguito de los rotadores pasaron a tener aumento de su incidencia con las avanzadas técnicas de diagnóstico por imagen y artroscópicas. La Resonancia Magnética Nuclear (RM) presenta buena sensibilidad y especificidad permitiendo una adecuada exactitud diagnóstica. Objetivo: evaluación de la concordancia entre observadores de la imagen RM para Lesiones del TMSE comparada a la artroscopia. Métodos: 49 pacientes sintomáticos fueron sometidos a la RM para diagnóstico de lesión del TMSE y evaluación de la Clasificación de Lafosse, teniendo su concordancia evaluada a través de la Artroscopia diagnóstica. Resultados: La exactitud global fue 68% para concordancia diagnóstica de la Lesión del TMSE y el 57,1% para concordancia en la clasificación de Lafosse. Discusión: se obtuvo concordancia para el diagnóstico de Lesión o ausencia de Lesión del TMSE de 0,49 y la concordancia para la Clasificación de Lafosse fue de 0,30. Conclusión: el diagnóstico de la lesión del TMSE a través de la RM es de difícil realización(AU)

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Diferentes fatores que afetam o sistema nervoso central são considerados de risco para o bruxismo. Universitários não são imunes ao bruxismo, consumo de álcool e uso de tabaco apesar de sua formação e responsabilidade social. Avaliou-se a associação entre bruxismo, consumo de álcool e tabaco entre graduandos de Odontologia. Foram voluntários 180 estudantes (17-29 anos) da Faculdade de Odontologia de Araçatuba/ UNESP, divididos entre aqueles com e sem bruxismo, com base em critérios clínicos validados realizados por quatro examinadores com luz natural e espátula de madeira. Bruxismo foi registrado nas seguintes categorias: sem facetas de desgaste; facetas no esmalte; facetas na dentina; facetas em metade da coroa e facetas em mais de 2/ 3 da coroa. Auto-questionário validado para o consumo de álcool e tabaco, com 29 perguntas foi respondido pelos dois grupos. Teste T e Exato de Fischer foram aplicados. Bruxismo foi mais frequente entre tabagistas, tanto em homens (68,4%) como mulheres (56,8%). Entre os indivíduos com bruxismo, 82,6% relataram que gostariam de parar de fumar e aqueles que anteriormente tentaram (76,4%) sentiram-se mais estressados ao parar. O consumo de álcool também foi mais frequente no grupo com bruxismo (66,5% no gênero feminino e 73,5% no masculino). 88,4% relataram consumir álcool “para lidar com o estresse de forma adequada”. Resultados sugerem associação positiva entre bruxismo, consumo de álcool e tabagismo

The etiology of bruxism is not well defined. Different factors affecting the central nervous system are considered as risk factors for bruxism. Dental students are not immune to the bruxism, alcohol consumption and tobacco use, despite their training, knowledge of its effects and social responsibility. The purpose of this study was to evaluate the association between bruxism, alcohol consumption and tobacco use among Brazilian dental students. Participants were chosen among 180, 17-29 year-old students at the UNESP’s Dentistry School – Araçatuba Campus. They were divided into those with and without bruxism on the basis at validated clinical criteria. The clinical examinations were carried out by four standardized examiners (Intraexaminer and Interexaminer Unweighted kappa= 0.82, Weighted kappa= 0.89, respectively), in the clinic, with daylight and a tongue depressor. Bruxism was registered with the following categories: no wear facets, wear facets in enamel, dentine wear facets, facets wear half of the crown and wear facets more than 2/3 of the tooth crown. A self report validated questionnaire for alcohol consumption and tobacco use with 29 questions was completed by both groups. Fischer exact test and T-test were used and Odds Ratio and Confidence Interval was estimated. Bruxism was more frequent among cigarette smokers both in men (68.4%) and in women (56.8%). Among all respondents in this group, 82.6% reported that they would like to quit smoking and those who have tried previously to quit (76.4%) found it made them more stressed. Drinker was more frequent in the group with bruxism also (66.5% of the female and 73.5% of the male). 88.4% reported drinking alcohol because it “allows dealing with stress in an adequate way”. Results suggest a positive association between bruxism and alcohol consumption and tobacco use

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O crescimento craniofacial é o resultado da interação de mecanismos genéticos, hormonais e neurológicos, influenciados pela ação do meio ambiente e da função. As variações das funções normais de respiração, mastigação, deglutição, sucção e fonação, podem, devido à sua interdependência morfofuncional com o crescimento da face, resultar em má oclusões, as quais exercem papel determinante na conformação óssea e neuromuscular do sistema estomatognático. A prevenção e interceptação dos hábitos parafuncionais é de fundamental importância para o desenvolvimento físico e emocional da criança. O propósito deste trabalho foi determinar a prevalência de hábitos parafuncionais em alunos do ensino fundamental do Colégio Ipê de Assis (Assis, SP). No presente estudo foi aplicado questionário proposto pelo Núcleo de Diagnóstico e Tratamento das DTMs da Faculdade de Odontologia de Araçatuba, Unesp. O universo e a amostra foram compostos pelos 80 alunos do ensino fundamental do Colégio Ipê de Assis (Assis, SP). A execução do projeto foi autorizada pelo Comitê de Ética em Pesquisa da Faculdade de Odontologia de Araçatuba/Unesp.Todos os responsáveis pelos alunos receberam instrução arespeito da pesquisa quanto à preservação de identidade e prestação de esclarecimentos em caso de dúvida. Ademais, foi solicitado que assinassem otermo de consentimento esclarecido, a fim de viabilizar a participação dos alunos. Os alunos (10 a 14 anos0 foram classificados em dois grupos: Grupo I – gênero feminino e Grupo II - gênero masculino. Além disso, os Grupos I e II foram classificados segundo as séries em curso e os hábitos bucais apresentados. Entre os hábitos parafuncionais detectados, mascar chiclete foi o hábito mais prevalente para ambos os grupos (72,2% no Grupo I e 78,5% no Grupo II) e em todos os anos, seguido de apoiar a mão no queixo (69,5% para o Grupo I e 67% para o Grupo II). Morder a língua foi o hábito menos prevalente no Grupo II e dormir de bruços no Grupo I. A alta...

The etiology of TMD in children and adolescents is considered multifactorial and has been related to parafunctional habits.The objective of this research was to determine the prevalence of parafunctional habits in elementary school students of “Colégio Ipê de Assis” (Assis, SP - Brazil). In the present research was administered questionnaire (15 questions) proposed by the Center for Diagnosis and Treatment of TMD, School of Dentistry of Araçatuba, UNESP. The sample was composed of 80 elementary school students of the “Colégio Ipê de Assis” (Assis, SP - Brazil). The project was approved by the Ethics Committee in Research of the School of Dentistry of Araçatuba/ UNESP. All parents and responsible of the students received instruction about the research and preservation of identity and provide clarification if in doubt. Beyond that, they were requested to sign the informed consent in order to facilitate the participation of students. Females comprised 47,5% and males 52,5%, with age ranging from 10 to 14. The students were classified into two groups as follows: Group I-female, Group II- male. In addition, brazilian students from Groups I and II were classified according to type of oral habits presented. All students presented a parafunctional habit. Among the parafunctional habits chewing gum was the most common in both groups (72.2%, Group I and 78.5%, Group II) followed by resting chin on hand for both genders (69,5% for Group I and 67% for Group II). Tongue biting (5%) was less founded in Group II and stomach sleeping in Group I. The results obtained show the necessity of carring out preventive programs. Beside, resources of Health should increase preventive treatments

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RESUMO

Definida como um conjunto de sinais e sintomas auditivos em pacientes portadores de DTM, a Síndrome de Costen é caracterizada por sensação de plenitude auricular, hipoacusia, zumbido, otalgia e vertigem com nistagmo. Herpes, glossodinia, neuralgia glossofaringeal e trismo também podem estar associados. A Síndrome de Costen parece ter predileção pelo sexo feminino e na quarta década de vida. O acompanhamento multiprofissional desses pacientes é imperativo no seu reconhecimento e no estabelecimento de terapêutica eficaz. Relatou-se caso clínico de paciente com Síndrome de Costen cujo tratamento consistiu na orientação sobre a etiologia da desordem e sessões semanais de acupuntura. As características clínicas que levaram ao diagnóstico e plano de tratamento, bem como a eficácia da acupuntura como terapêutica de suporte também foram discutidas

Costen’s syndrome is defined as a set of auditory signs and symptoms in patients with TMD. It is characterized by ear fullness, hearing loss, tinnitus, ear pain and vertigo with nystagmus.It has predilection for females and fourth decade of life. The multidisciplinary monitoring of these patients is imperative in its recognition and the establishment of effective therapy. In this paper we report a case of Costen’s Syndrome patient whose treatment consisted of advice on the etiology of the disorder and weekly sessions of acupuncture. The clinical features that led to the diagnosis and treatment plan, and the effectiveness of acupuncture as supportive therapy were also discussed

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