RESUMO

As características dos músculos faciais, a variação do formato e a configuração facial, tanto no sentido vertical como no sentido horizontal, determinam a classificação de tipo facial. Observar o tipo facial é importante, pois indivíduos com diferentes tipos faciais apresentam características próprias. O objetivo deste estudo foi avaliar a ocorrência do bruxismo do sono e em vigília e suas características clínicas entre adolescentes dolicofaciais, braquifaciais e mesofaciais. Quatrocentos e três indivíduos participaram. O tipo facial dos adolescentes (dolicofacial, braquifacial ou mesofacial) foi determinado através do Índice facial. O possível bruxismo do sono e em vigília foram avaliados por meio de um questionário de auto relato. As características clínicas dor nos músculos temporal e masseter, ronco, hábito de babar no travesseiro, marcas na língua, linha alba, desgaste em dentes anteriores, desgaste em dentes posteriores, máxima abertura de boca e atividade elétrica do músculo masseter também foram avaliadas. Foi realizada estatística descritiva e regressão multinomial. Os resultados foram expressos em odds ratio (OR) e intervalos de confiança (IC). Entre os 403 adolescentes, 234 (58,1%) eram do sexo feminino e 169 (41,9%) do sexo masculino. Em relação ao tipo facial, a maioria dos adolescentes apresentou o tipo dolicofacial (54,3%), seguido pelos adolescentes mesofaciais (26,1%) e aqueles que apresentaram o tipo braquifacial (19,6%). A média de idade dos adolescentes foi de 14,36 anos (±1,56). Adolescentes braquifaciais tinham menos chances de apresentarem possível bruxismo em vigília (algumas vezes) em comparação aos adolescentes mesofaciais (OR=0,45, IC=0,210,98). Adolescentes braquifaciais tinham mais chances de apresentarem dor no músculo temporal (OR=6,58, IC=2,17-19,93) e um número maior de dentes posteriores com desgaste (OR=1,24, IC=1,02-1,52) em comparação aos adolescentes mesofaciais. Adolescentes dolicofaciais tinham mais chances de não apresentarem dor no músculo masseter (OR=2,21, IC=1,02-4,79), de apresentarem um maior ângulo de abertura de boca (OR=1,58, IC=1,13-2,20), um número maior de dentes posteriores com desgaste (OR=1,17, IC=1,00-1,38) e babar no travesseiro algumas vezes (OR=2,06, IC=1,15-3,68) em comparação aos adolescentes mesofaciais. Adolescentes dolicofaciais tinham mais chances de não apresentarem dor no músculo temporal (OR=5,73, IC=2,12-15,49), de não apresentarem marcas de edentação na língua (OR=2,23, IC=1,08-4,57) e de apresentarem um maior ângulo de abertura de boca (OR=2,18, IC=1,46-3,24) quando comparados a adolescentes braquifaciais. O bruxismo e suas características clínicas diferiram entre adolescentes dolicofaciais, braquifaciais e mesofaciais.

The characteristics of the facial muscle, the variation of the shape of the face, both vertically and horizontally, determine the facial type of an individual. Diagnosis of the facial type and its associated features is important, since individuals with different facial types have their own characteristics. The objective of this study was to compare the occurrence of sleep and awake bruxism and their associated clinical characteristics among dolichofacial, brachyfacial and mesofacial adolescents. Four hundred three individuals participated. Adolescents? facial type (dolichofacial, brachyfacial or mesofacial) was determined. Possible sleep and awake bruxism were assessed. The clinical characteristics pain in the masseter and in the temporal muscle, snoring, drooling on the pillow, indentations marks on the tongue, linea alba on the inner cheek, attrition in anterior teeth, attrition in posterior teeth, maximum opening of the mouth and electrical muscle activity were also evaluated. Descriptive statistics and multinomial regression were performed. Results were provided in odds ratio (OR) e confidence intervals (CI). Among the 403 adolescents, 234 (58.1%) were female individuals and 169 (41.9%) were male individuals. As regards the facial type, most adolescents presented a dolichofacial facial type (54.3%), followed by adolescents with mesofacial facial type (26.1%) and those presenting a brachyfacial facial type (19.6%). Adolescents? mean age was 14.36 years. Brachyfacial adolescents were less likely to present possible awake bruxism compared to mesofacial adolescents (OR=0.45, CI=0.21-0.98). Brachyfacial adolescents were more likely to present pain in the temporal muscle (OR=6.58, CI=2.17-19.93) and a higher number of posterior teeth with attrition (OR=1.24, CI=1.02-1.52) compared to mesofacial adolescents. Dolichofacial adolescents were more likely of not presenting pain in the masseter muscle (OR=2.21, CI=1.02-4.79), had a greater maximum opening of the mouth (OR=1.58, CI=1.13-2.20), had a higher number of posterior teeth with attrition (OR=1.17, CI=1.00-1.38) and were more likely to drool on the pillow sometimes (OR=2.06, CI=1.15-3.68) compared to mesofacial adolescents. Dolichofacials adolescents were more likely of not presenting pain in the temporal muscle (OR=5.73, CI=2.12-15.49), to present themselves without marks on the tongue (OR=2.23, CI=1.08-4.57) and with a greater maximum opening of the mouth (OR=2.18, CI=1.46-3.24) compared to brachyfacial adolescents. Bruxism and its clinical characteristics differ among dolichofacial, brachyfacial and mesofacial adolescents.

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RESUMO

OBJECTIVES: To measure the lengths of the force and resistance arms, in order to calculate the mechanical advantage and muscular work of the human temporalis muscle (TM) in brachyfacial (BR) and dolichofacial (DO) subjects. SETTING AND SAMPLE POPULATION: Mandibles from 49 subjects of both genders (BR n = 9; DO n = 40) from the collection of the Laboratory of Human Anatomy at Universidade de Santa Cruz do Sul, Rio Grande do Sul, Brazil, were analyzed. MATERIAL AND METHODS: The distance between the condylar process and the coronoid process (insertion site of the TM) represented the length of the force arm (LFA ) of the TM. The distance between the condylar process and the mental protuberance represented the length of the resistance arm (LRA ). Thus, the mechanical advantage of the TM was obtained using the following ratio: LFA /LRA , while the muscular work (LRA /LFA ) of the TM was obtained using the inverse of this ratio. RESULTS: When compared with the DO, the parameters of the BR are significantly greater, as shown by the LFA (6.0%) and mechanical advantage (8.2%; p = 0.0078). By contrast, our results show that in the DO, the LRA was 2.4% longer and the muscular work was 10.4% greater (p = 0.0087). CONCLUSION: The mechanical advantage of the TM in BR subjects is significantly greater than in DO subjects. Moreover, this greater mechanical advantage may explain, at least in part, the higher incidence of temporomandibular dysfunctions in BR subjects.

Assuntos