Avaliação do espaço articular na posição mandibular de repouso, em pacientes sintomaticos e assintomaticos nas desordens temporomandibulares

AUTOR(ES)
DATA DE PUBLICAÇÃO

2001

RESUMO

Considering the importance of the mandibular physiological rest position in the temporomandibular disorders context, the purpose of these studies was to evaluate the articular space of patients with and without symptom, on sagital and frontal incidence through the conventinonal hipocic1oidal corrected tomography. Sixty seven patients were selected, twenty nine volunteers without symptoms and thirty eight c1inically diagnosed as having temporomandibular disorder symptoms. Qut of this number forty were female and twenty seven were male, the average age being 31 years old. During the tomographyc exam, the habitual head position was maintained and the customary posture was c1inically analized since this is considered a factor which can modify the mandibular rest position. It is important to point out that this observation shows a tendency towards anterior head position. It is described in literature characteristic of the TMD patients. The tomography exam was accomplished bilaterally; with the slices taken from the central portion both in the anteroposterior and mediolateral direction and the images obtained were submitted to a graphic methodology and measured at random. The statistical results of the test "t" Student allowed us to conc1ude that there were no ditIerences in the average measurements of the right and left side of each patient or between patients with and without symptoms. The main difference was between males and females showing major dimension for the former. The homogeneity of the average linear measurement showed in the TMJ tridimensional analysis, the anterior region having smaller dimensions than the posterior and the latter smaller than the superior region confirming the anterosuperior posture of the rest position, in regard to the articular fossa and distinguishing it from the maximum intercuspidation position, which is known to be more anterosuperior. In the frontal slice it was verified that the dimensions of the articular space in the mediolateral direction were more proportional, configuring a smaller dimension for the lateral pole, which is considered the zone with major degenerative problems. Statistically, in the same way, as in the maximum intercuspidation the male articular spaces in the mandibular rest position, both anteroposterior and mediolateral directions, are bigger than those of the females, suggesting that the forme r is biologically more protected from the articular deleterious factors and so is less susceptible to these disorders. The re_mlts show that with the methodology applied, it is perfectly possible to reproduce and measure the mandibular rest position even though it has been considered an intermediary and apparently instable position, showing the importance oí continuing intensive research in order to emphasize the maintenance oí the neuromuscular balance in the context oí temporomandibular disorders

ASSUNTO(S)

tomografia articulação temporomandibular

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