Journal articles on the topic 'Costen's syndrome'

Although James Costen was not the first to ascribe ear pain, tinnitus, impaired hearing, and even dizziness to temporomandibular joint dysfunction, he developed an integrated and systematic approach ascribing the symptoms to dental malocclusion. He wrote extensively on it, and a few years after his original article, the term Costen's syndrome came into general use. Recently, the use of the eponym has decreased, as dental malocclusion has assumed a lesser role in explaining many of the symptoms formerly ascribed to it.

Introduction. The relevance of the study is due to the complexity of the differential diagnosis of Kosten's syndrome and meningioma in the area of the cerebellar bridge angle of the brain, as well as the severe suffering of patientsThe purpose of our study: development of an algorithm for the approach to the differential diagnosis of meningioma of the cerebellar angle and Kosten's syndrome.Materials and methods. To accomplish the set tasks, we examined 22 patients who complained of headache, hearing impairment, sensation of tinnitus, pain and crepitus in the temporomandibular joint during movements of the lower jaw, paresthesia of the oral and nasal mucosa. All patients were assigned studies: cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) of the TMJ according to indications.Results. Since complaints can lead patients to see doctors of various specialties, it is necessary to be able to differentiate between Costen's syndrome and a tumor of the cerebral pons-cerebral angle. In Costen's syndrome, the pain most often has an aching character, in contrast to the volumetric formations of the brain, in which the pain is burning, spreading along the branches of the facial or trigeminal nerve. One of the main methods of excluding a brain tumor is magnetic resonance imaging.Conclusions. The most significant modern method for diagnosing Costen's syndrome and meningioma of the cerebellopontine angle is magnetic resonance imaging (MRI) of the TMJ and the brain. Differential signs of Costen's syndrome are distal displacement of the head of the lower jaw, diagnosed by CBCT and MRI, as well as displacement of the articular disc (determined by MRI). A meningioma of the cerebellopontine angle is indicated by the burning nature of pain in half of the face, as well as confirmation of the diagnosis by magnetic resonance imaging of the brain.

Relevance. Our study aimed to determine the main differential diagnosis criteria for temporomandibular joint (TMJ) pain dysfunction syndrome (temporomandibular disorders, Costen's syndrome) and cerebellopontine angle tumours.Materials and methods. We examined 22 people (19 women and three men), aged 21 to 74 years (mean age 37.2 ± 5.1 years), who presented to the prosthodontic clinic with facial pain.Results. The study proposed the following differential diagnostic criteria for TMJ pain dysfunction syndrome and brain tumors: different nature of pain, unilateral ear noise; distal displacement of the mandibular head diagnosed by cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI), as well as articular disc displacement (detected by MRI) in temporomandibular disorders. Unilateral facial burning pain indicated meningioma of the cerebellopontine angle, which head MRI confirmed.Conclusion. The proposed table for evaluating clinical and paraclinical study methods for patients with facial pain helps to differentiate the cause of pain properly and proceed with the optimal treatment method.

Temporomandibular joint disease (TMJ) is one of the most pressing problems of modern dentistry, on the one hand, the frequency of pathology of the temporomandibular joint, and on the other hand - the complexity of diagnosis. In the medical specialty "dentistry" there is no section where there would be as many debatable and unresolved issues as in the diagnosis and treatment of diseases of the temporomandibular joints. Aim of the research. Based on the analysis of sources of scientific and medical information to determine the role and place of "Costen's syndrome" in the pathology of the temporomandibular joints. Results and discussion The term TMJ dysfunction has up to 20 synonyms: dysfunction, muscle imbalance, myofascial pain syndrome, musculoskeletal dysfunction, occlusal-articulation syndrome, cranio-mandibular TMJ dysfunction, neuromuscular and articular dysfunction. Finally, in the International Classification of Diseases (ICD-10), pain dysfunction of the temporomandibular joint has taken its place under the code K0760 with the additional name "Costen's syndrome", which is given in parentheses under the same code. Thus, such a diagnosis as "Costen's syndrome" is not excluded in the International Classification of Diseases. The first clinical symptoms and signs of TMJ were systematized in 1934 by the American otorhinolaryngologist J. Costen and included in the special literature called "Costen's syndrome". This syndrome includes: pain in the joint, which often radiates to the neck, ear, temple, nape; clicking, crunching, squeaking sound during movements of the lower jaw; trismus; hearing loss; dull pain inside and outside the ears, noise, congestion in the ears; pain and burning of the tongue; dizziness, headache on the side of the affected joint, facial pain on the type of trigeminal neuralgia. The author emphasized the great importance of pain and even singled out "mandibular neuralgia." The criteria proposed by McNeill (McNeill C.) in 1997 are somewhat different from those described in ICD-10: pain in the masticatory muscles, TMJ, or in the ear area, which is aggravated by chewing; asymmetric movements of the lower jaw; pain that does not subside for at least 3 months. The definition of the International Headache Society is similar in content. Anatomical and topographic study of the corpse material suggested the presence of a structural connection between the TMJ and the middle ear. According to some data, in 68% of cases the wedge-shaped mandibular ligament reaches the scaly-tympanic fissure and the middle ear, and in 8% of cases it is attached to the hammer. In addition, several ways of spreading inflammatory mediators from the affected TMJ to the middle and inner ear, which causes otological symptoms, have been described. It should be noted that there are certain prerequisites for the mutual influence of the structures of the cervical apparatus, middle and inner ear and upper cervical region at different levels: embryological, anatomical and physiological. At the embryological level. It is confirmed that from the first gill arch develops the upper jaw, hammer and anvil, Meckel's cartilage of the lower jaw, masticatory muscles, the muscle that tenses the eardrum, the muscle that tenses the soft palate, the anterior abdomen of the digastric muscle, glands, as well as the maxillary artery and trigeminal nerve, the branches of which innervate most of these structures. At the anatomical level. Nerve, muscle, joint and soft tissue structures of this region are located close enough and have a direct impact on each other. The location of the stony-tympanic cleft in the medial parts of the temporomandibular fossa is important for the development of pain dysfunction. At the physiological level. A child who begins to hold the head, the functional activity of the extensors and flexors of the neck gradually increases synchronously with the muscles of the floor of the mouth and masticatory muscles, combining their activity around the virtual axis of the paired temporomandibular joint. In addition, the location of the caudal spinal nucleus of the trigeminal nerve, which is involved in the innervation of the structures of the ear, temporomandibular joint and masticatory muscles at the level of the cervical segments C1-C3 creates the possibility of switching afferent impulses from the trigeminal nerve to the upper cervical system. Innervate the outer ear, neck muscles and skin of the neck and head. Also important are the internuclear connections in the brainstem, which switch signals between the vestibular and trigeminal nuclei. That is why the approach to the treatment of this pathology should be only comprehensive, including clinical assessment of the disease not only by a dentist or maxillofacial surgeon, but also a neurologist, otorhinolaryngologist, chiropractor, psychotherapist with appropriate diagnostic methods and joint management of the patient.

AbstractObjective:Otological symptoms (otalgia, subjective hearing loss, blocked ear sensation, tinnitus and vertigo) associated with temporomandibular disorders are documented features of Costen's syndrome. However, the origin of these symptoms and the causes of hearing loss are unknown. This study aimed to characterise hearing loss in a large number of patients with temporomandibular disorders. The causes of these symptoms were explored in patients with otological symptoms and normal audiometric findings.Methods:A prospective case study and literature review were performed. The audiometric features of 104 temporomandibular disorder patients were compared with those of 110 control participants.Results:A large proportion of temporomandibular disorder patients had several otological symptoms. Twenty-five per cent of unilateral or bilateral temporomandibular disorder patients had either unilateral (ipsilateral) or bilateral hearing loss; respectively, which was usually mild (p = 0.001). Hearing loss was predominantly sensorineural.Conclusion:The main cause of otological symptoms (apart from otalgia) and of audiometric findings in temporomandibular disorder patients is postulated to be an altered middle-ear to inner-ear pressure equilibrium.

The incidence of temporomandibular joint dysfunction in women reaches 80% of the total number of patients. The symptoms of temporomandibular joint dysfunction are varied and were first described by otorhinolaryngologist J.B. Costen. In his honor, the entire symptom complex of this disease is named "Costen's syndrome" in specialized literature and in the International Classification of Diseases of the tenth revision. The symptom complex includes joint pain, sometimes radiating to the neck, back of the head, temple, ear, clicks in the joint during movements of the lower jaw, trismus, hearing loss, dull pain in the middle and outside the ear, pain and burning sensation of the tongue, dry mouth; dizziness, pain on the side of the affected joint and even facial pains like trigeminal neuralgia. It is clinically difficult to isolate all these symptoms in patients with dysfunction of the temporomandibular joint, because its pathogenic and etiological manifestation is characterized in most cases only by one or several symptoms. Temporomandibular joint dysfunction is polyetiological, has a varied clinical picture and is directly dependent on the hormonal state, and especially the gynecological status. Much attention is drawn to the study of estrogen, which, in addition to regulating the functioning of the reproductive system in a woman's body, also performs a number of other important functions, including helping the joint to remain healthy - preventing calcium leaching, stimulating collagen recovery and the work of osteoblasts. The aim of the study was to determine the frequency of temporomandibular joint dysfunction in women along with hormonal changes and to trace their correlation. Materials and methods. The study involved 169 students of the third year at the Department of Propedeutics of Surgical Dentistry of the Faculty of Dentistry of the Ukrainian Medical Stomatological Academy. The research methods were based on conducting an anonymous survey. The questions were written for both men and women and were characterized by general dental status. Questions on gynecological status were asked separately for women. Results and discussion. The study group consisted of 169 people, including 89 women and 80 men aged 18 to 28 years. 61% of men and 26% of women did not have complicated dental status, among those surveyed. At the same time, 35% of men (of their total number) and 28% of women (of their total number) had orthodontic pathology. The presence of individual symptoms of temporomandibular joint dysfunction in men was observed in 6% of the total number of patients, in women - 19% (4% of them had already consulted a dentist, but did not receive adequate treatment). It is worth noting that patients with suspected temporomandibular joint pathology complained only of clicks when opening their mouths or chewing. Among 89 women studied, 8% had temporomandibular joint dysfunction, but did not have pathologies of the reproductive system. In 20% of women who did not have temporomandibular joint dysfunction, pathology of the reproductive system was noted. 11% had temporomandibular joint dysfunction and pathology of the reproductive system. 26% of women were clinically healthy. Out of 10 women with temporomandibular joint dysfunction who had a pathology of the reproductive system, but never had problems with the dentition, 10% of the women in the group (1% of all women examined) suffered from menstrual irregularities and had human papillomavirus in their anamnesis. 20% had a suspicion of temporomandibular joint pathology along with problems in their gynecological status and a history of orthodontic treatment, 10% had menstrual irregularities (algodismenorrhea) and were treated by a gynecologist with hormonal contraceptives for up to 1.5 years. 30% of women had temporomandibular joint pathology with problems in their gynecological status and previous therapeutic treatment (presence of fillings in the oral cavity). Of these, 20% have menstrual irregularities, and 10% have cervical erosion. 40% of the total number of women had temporomandibular joint pathology with orthodontic treatment in the past and fillings in the oral cavity along with problems in their gynecological status, where all had menstrual irregularities. 10% of them had metaplasia, erosion of the cervix and uterine polyp, 10% - erosion of the cervix. It should be noted that out of 89 women, 14 (17.5%) did not have any complaints about the condition of the joint, but had fillings and orthodontic treatment in the past, as well as pathology of the reproductive system. 11 of them (14%) had menstrual irregularities. In 3 (4%) patients out of the total number of women, there was an increased level of androgens, progesterone, estradiol and a history of treatment by a gynecologist. Based on the results obtained, it is possible to confirm the forced frequency of women visiting the dentist. Among the total number of women with temporomandibular joint dysfunction and pathology of the reproductive system, there was only 1 patient out of 89 persons without any dental interventions in the past. This does not give us a reason to associate gynecological status with the etiology of temporomandibular joint dysfunction. But in view of the greater prevalence of temporomandibular joint dysfunction along with gynecological pathologies, it gives us a basis for active further research on this topic.

Background: Temporomandibular joint syndrome, or Costen syndrome, is a clinically diagnosed disorder whose most common symptoms include joint pain and clicking, difficulty opening the mouth, and temporomandibular joint discomfort. The temporomandibular joint (TMJ) is supplied by the auriculotemporal nerve, a collateral branch of the mandibular nerve (the V3 branch of the trigeminal nerve). Objectives: The aim of this study is to assess the effectiveness and safety of permanent peripheral nerve stimulation to relieve TMJ pain. Study Design: This case series is a prospective study. Setting: Pain Unit of a regional universitary hospital. Methods: The study included 6 female patients with temporomandibular pain lasting from 2 to 8 years that did not respond to intraarticular local anesthetic and corticoid injections. After a positive diagnostic block test, the patients were implanted with quadripolar or octapolar leads in the affected preauricular region for a 2-week stimulation test phase, after which the leads were connected to a permanent implanted pulse generator. Results of the visual analog scale, SF-12 Health Survey, Brief Pain Inventory, and drug intake were recorded at baseline and at 4, 12, and 24 weeks after the permanent implant. Results: Five out of 6 patients experienced pain relief exceeding 80% (average 72%) and received a permanent implant. The SF-12 Health Survey results were very positive for all specific questions, especially items concerning the physical component. Patients reported returning to normal physical activity and rest at night. Four patients discontinued their analgesic medication and 1 patient reduced their gabapentin dose by 50%. Limitations: Sample size; impossibility of placebo control. Conclusion: Patients affected with TMJ syndrome who do not respond to conservative treatments may find a solution in peripheral nerve stimulation, a simple technique with a relatively low level of complications. Key words: Temporomandibular joint disorder, temporomandibular joint syndrome, Costen syndrome, peripheral nerve stimulation, auriculotemporal nerve stimulation, preauricular block, clinical safety and effectiveness, trigeminal neuralgia

Introdução: A Síndrome de Marfan é uma desordem genética que afeta o tecido conectivo. No contexto da Odontologia, poucos profissionais da área conhecem os sintomas da síndrome, bem como os cuidados necessários no atendimento ao paciente. Objetivo: O objetivo deste trabalho foi descrever as características anatômicas gerais e bucais de pessoas com Síndrome de Marfan. Material e método: Foram realizadas pesquisas nas bases de dados EBSCO, Bireme e Pubmed entre os anos de 2017 e 2018, sendo utilizados os seguintes descritores: Síndrome de Marfan AND Odontologia AND Manifestações bucais. Resultados: Foram localizados 13 artigos na base de dados BIREME, 23 no PubMed e cinco no EBSCO, totalizando 41 artigos. Desses, 10 foram selecionados para a realização desta pesquisa. As principais alterações gerais descritas na literatura incluem membros superiores e inferiores longos, pé chato, corpo fino com o segmento inferior maior que o segmento superior, aracnodactilia, peito plano com costelas proeminentes e escoliose, pectus carinatum, pectus excavatum, cifose, hiperextensibilidade, dolicostenomelia, alterações oculares e problemas cardíacos. As principais alterações bucais descritas incluem hipoplasia maxilar, retrognatia mandibular, macrostomia, dentição altamente apinhada com mordidas cruzadas anteriores e posteriores, palato de arco alto e relação molar classe II de Angle em ambos os lados e apresentam maior índice de doenças periodontais do que pacientes normais. Conclusões: Os principais cuidados que devem ser observados durante o tratamento odontológico relacionam-se a anamnese e ao exame clínico. O melhor entendimento dessa patologia poderá orientar decisões terapêuticas para prevenção e correção das desordens mencionadas neste trabalho. Descritores: Síndrome de Marfan; Odontologia; Manifestações Bucais. Referências Muñoz Sandoval J, Saldarriaga-Gil W, Isaza de Lourido C. Síndrome de Marfan, mutaciones nuevas y modificadoras del gen FBN1. 2014;27(2):206-15. García JLG, Cedeño LM, Medina JAG. Síndrome de Marfan. Medisan. 2007;11(4):1-5. Pfeiffer MET. Síndrome de Marfan em crianças e adolescentes: importância, critérios e limites para o exercício físico. Rev DERC. 2011;17(3):82-6. Lebreiro A, Martins E, Cruz C, Almeida J, Maciel MJ, Cardoso JC, et al. Síndrome de Marfan: manifestações clínicas, fisiopatologia e novas perspectivas da terapêutica farmacológica. Rev Port Cardiol. 2010; 29(6):1021-36. Velásquez C. Manejo odontológico integral en centro quirúrgico de un paciente con Sindrome de Marfan. Odontol Pediatr (Lima). 2015;14(1):80-5. Tsang AK, Taverne A, Holcombe T. Marfan syndrome: a review of the literature and case report. Spec Care Dentist. 2013;33(5):248-54. Bilodeau JE. Retreatment of a patient with Marfan syndrome and severe root resorption. Am J Orthod Dentofacial Orthop. 2010;137(1):123-34. Baraldi CEE, Paris MF, Robinson WM. A síndrome de Marfan e seus aspectos odontológicos: relato de caso e revisão da literatura. Rev Fac Odontol Porto Alegre. 2008;49(3):36-9. Sinha A, Kaur S, Raheel SA, Kaur K, Alshehri M, Kujan O. Oral manifestations of a rare variant of Marfan syndrome. Clin Case Rep. 2017;5(9):1429-34. Anuthama K, Prasad H, Ramani P, Premkumar P, Natesan A, Sherlin HJ. Genetic alterations in syndromes with oral manifestations. Dent Res J (Isfahan). 2013;10(6):713-22. Jain E, Pandrey RK. Marfan Syndrome. BMJ Case Rep. 2013;25(16):16-22. Staufenbiel I, Hauschild C, Kahl-Nieke B, Vahle-Hinz E, von Kodolitsch Y, Berner M, et al. Periodontal Conditions in patients with Marfan Syndrome: a multienter case conrol study. BMC Oral Health. 2013;13:59. Mallineni SK, Jayaraman J, Yiu CK, King NM. Concomitant occurrence of hypohyperdontia in a patient with Marfan syndrome: a review of the literature and report of a case. J Investig Clin Dent. 2012;3(4):253-57. Gott VL. Antoine Marfan and his syndrome: one hundred years later. Md Med J. 1998;47(5):247-52. Alves IC, Navarro F. Exercício fisico e sindrome de Marfan. Rev Bras Prescrição e Fisiologia do Exercício. 2008;2(8):149-57. Sivasankari T, Mathew P, Austin RD, Devi S. Marfan Syndrome. J Pharm Bioallied Sci. 2017;9(1):73-7. Sabbatini IF. Avaliação dos components anatômicos do sistema estomatognático de crianças com bruxismo, por meio de imagens obtidas por tomografia computadorizada cone beam [dissertação de Mestrado]. Ribeirão Preto: Universidade do Estado de São Paulo; 2012. Cistulli PA, Richards GN, Palmisano RG, Unger G, Berthon-Jones M, Sullivan CE. Influence of maxillary constriction on nasal resistance and sleep apnea severity in patients with Marfan's syndrome. Chest. 1996;110(5):1184-8.

RESUMO Introdução: A Síndrome do Desfiladeiro Torácico (SDT) é uma entidade clínica com sintomatologia diversa, decorrente de compressão anormal do plexo braquial, na região do desfiladeiro torácico. Esta compressão é exercida, na maioria das vezes, pelo músculo escaleno anterior, mas pode resultar também da existência de bandas musculofibróticas, alteração da morfologia da primeira costela, costelas cervicais e músculos anômalos. A SDT pode ser classificada nos tipos vascular e neurogênico. Descrição do caso: Paciente, sexo feminino, 27 anos, com quadro de dor e parestesia, há dois anos, de início insidioso, em 4º e 5º quirodáctilos e, posteriormente, com progressão para todo membro superior esquerdo (MSE). Procurou Unidade de Pronto Atendimento, sendo prescrito apenas medicação analgésica. Após três dias, apresentou intensificação da dor, associada a palidez e parestesia de MSE procurando atendimento no Hospital Geral de Palmas. Discussão: A SDT acomete mais mulheres entre 20-50 anos, com vários fatores contribuintes, chegando a limitar as atividades diárias e laborais. O tratamento clínico, frequentemente, é a conduta inicial, procurando aliviar os sintomas. Em geral, o tratamento cirúrgico tem indicação em 15 % dos casos, quando a síndrome é decorrente de anomalias ósseas sintomáticas e complicações vasculares. Palavras-chave: Síndrome do Desfiladeiro Torácico; Costela Cervical; Plexo Braquial. ABSTRACT Introduction: Thoracic Outlet Syndrome (TOS) is a clinical entity with diverse symptomatology due to abnormal compression of brachial plexus in the thoracic outlet region. This compression is often carried out by the anterior scalene muscle, but it may be a result from the presence of musculofibrotic bands, alteration of the first rib morphology, cervical ribs and anomalous muscles. TOS can be classified into vascular and neurogenic types. Case description: Patient, female, 27 years old, with pain and paresthesia, since two years ago, insidious onset, in 4th and 5th fingers, and later with progression to all left upper limb (LUL). She looked for Emergency Care Unit, and only analgesic medication was prescribed. After three days, she presented pain intensification, associated with pallor and paresthesia of LUL, looking for care at the General Hospital of Palmas. Discussion: The TOS affects more women between 20-50 years old, with several contributing factors, limiting daily activities and work. The clinical treatment, often, is the initial conduct, seeking to relieve symptoms. In general, the surgical treatment is indicated in 15% of cases, when the syndrome is due to symptomatic bone anomalies and vascular complications. Keywords: Thoracic Outlet Syndrome; Cervical Rib; Brachial Plexus.

Introdução: Tumores de Pancoast constituem um subconjunto clinicamente único e desafiador de carcinoma de pulmão que estão associados a neoplasias nos ápices pulmonares. Apresentam como critérios característicos da lesão: infiltração da pleura parietal causando dor, parestesias ou outra disfunção neurológica. Esses tumores representam de 3% a 5% de todos os cânceres de pulmão, afetando mais homens, com idade média aos 60 anos, cujo o principal fator de risco é o tabagismo. O tempo médio entre o início dos sintomas e o diagnóstico varia de 5 a 10 meses, e por serem tratados sem maior investigação, levam a um prognóstico com menor sobrevida do paciente, sendo representado, de acordo com a Classification of Malignant Tumours (TNM), tipicamente, como T3 ou T4 ao diagnóstico. Como a maioria das alterações celulares, a biópsia ajuda na confirmação do diagnóstico e tratamento da doença, sem esquecer da apresentação clínica e achados nos exames de imagem e laboratoriais. Objetivo: Realizar uma revisão narrativa de literatura abordando as características que influenciam no tratamento e no prognóstico do Tumores de Pulmão de Pancoast. Metodologia: Os artigos científicos foram obtidos através de pesquisa nas bases de dados eletrônicos, como Up To Date, Scielo e PubMed, utilizando os seguintes descritores: tumor de pulmão, Pancoast, cirurgia torácica, pancoast syndrome e thoracic surgery. Foram selecionados 5 artigos publicados entre 2014 e 2022, buscados no período de setembro, outubro e novembro de 2022. A pesquisa se desenvolveu com base na questão condutora: “Quais os principais fatores levados em consideração na avaliação para o tratamento e para o prognóstico em pacientes com tumor de Pancoast”. Resultados: Os principais sítios de metástases são para fígado, cérebro, ossos e suprarrenais. Seu tratamento pode diferir de outros tipos de câncer de pulmão, sendo o mais radical a cirurgia, e sua posição e relação de proximidade do tumor com estruturas vitais podem dificultar seu prognóstico. Dependendo do estágio do câncer, o tratamento pode exigir rádio e quimioterapia antes da cirurgia, a qual pode consistir na remoção do lobo superior de um pulmão juntamente com suas estruturas associadas, como artéria subclávia, veia, ramos do plexo braquial, costelas e corpos vertebrais, devendo ser feita linfadenectomia mediastinal, procedimento mais comum, seguido de uma pneumectomia unilateral. Os tipos histológicos mais frequentes de neoplasias pulmonares são de células escamosas, seguida de adenocarcinoma, de pequenas células, de células grandes e de não pequenas células. O surgimento do quadro clínico varia de 3 meses a 2 anos, por seu caráter progressivo lento. Conclusão: Portanto, percebe-se que os preditores do tratamento mais agressivo e do pior prognóstico dos tumores de Pancoast são determinados pela localização no ápice do pulmão irrestritos ao segmento apical do lobo superior, além de não haver diferença entre lados direito e esquerdo do pulmão. O tipo histológico do tumor carcinoma não de pequenas células, e aqueles com invasão de costelas, plexo braquial e vasos subclávios, junto com metástase principalmente em osso, bem como pelo tempo do desenvolvimento da neoplasia superior à 6 meses após o surgimento dos sinais e sintomas do carcinoma.

Introdução: O câncer de pulmão ocupa o segundo lugar mundial em mortalidade geral, e é a principal causa de morte por neoplasia. Divide-se em tumor (TU) não pequenas células e tumor pequenas células, este sendo mais agressivo. A associação direta entre carga tabágica e a neoplasia faz do tabagismo fator de risco influenciador na gravidade da doença. O tumor de Pancoast é localizado no ápice do lobo superior pulmonar. A lesão exerce efeito de massa que culmina com compressão do plexo braquial, destruição das costelas contíguas, invasão da pleura parietal e eventualmente destruição vertebral e infiltrado medular. Em decorrência, surgem sinais e sintomas que configuram a síndrome de Pancoast como dor no ombro, a qual pode irradiar para tórax, cabeça, pescoço, braço ipsilateral e trajeto do nervo ulnar. Desenvolvimento: Relata-se o caso de um paciente, masculino, 49 anos, fumante há 34 anos, com Pancoast em estadio IV (T4N2M1) ao diagnóstico. O diagnóstico do tumor de Pancoast é obtido através da associação entre exame de imagem que evidencie a massa em ápice pulmonar, a relevante clínica do doente e biópsia confirmatória de neoplasia primária pulmonar. A frequência de metástases relaciona-se diretamente com o tipo histológico e grau de diferenciação, sendo o não diferenciado o mais relacionado. Os locais mais acometidos pelos implantes secundários são sistema nervoso central (SNC), osso, fígado, adrenais. Discussão: O prognóstico é ruim com tempo de sobrevida em 5 anos baixo, mesmo nos estádios iniciais. Hoje existem três modalidades de tratamento para a neoplasia pulmonar: radioterapia, quimioterapia e ressecção cirúrgica, a depender do estadiamento. O TU de Pancoast inicial apresenta-se como T3, embora seja passível de abordagem cirúrgica podendo ser completamente ressecado. A redução da prevalência do tabagismo permanece como estratégia soberana na prevenção da neoplasia pulmonar e de suas temidas consequências. Palavras-chave: Síndrome de Pancoast; câncer de pulmão; prevalência; mortalidade; tabagismo. ABSTRACT Introduction: Lung cancer takes the second place worldwide in general mortality and is the main reason of death by neoplasm. The classification of the tumor is split at non-small cells and small cells, this one being more aggressive. The direct association between smoking load and the neoplasm makes the smoking the biggest influencer in the seriousness of the disease. The Pancoast tumor takes place at pulmonary apices usually. The wound is associated with the mass effect, the destruction of local ribs, the invasion of parietal pleurae and, eventually, the spinal destruction and medullary infiltrate. As a result, the signs and symptoms that configures the Pancoast syndrome emerge, as the shoulder pain, which can irradiate to cheats, head, neck, ipsilateral arm and the path of ulnar nerve. Development: report a patient, male, 49 years, smoker by 34 years, with Pancoast tumor in stage IV (T4N2M1) at the diagnosis. Discussion: The association among the image exam that shows pulmonary apices’ mass, the relevant sick’s clinic and the confirmatory biopsy of primary pulmonary neoplasm takes the diagnosis of Pancoast tumor. The frequency of metastasis relates direct with the histological sort, being the not differenced the most related. The places with more impairment by the secondary implants are the central nervous system, bone, liver and adrenal. The prognostic is mean with time of survival in 5 years low even in initial stages. Nowadays there are three genres of treatment for the pulmonary neoplasm: radiotherapy, chemotherapy and surgery resection, which depends of the stage. The initial Pancoast tumor shows usually as T3 however could be believable of surgical approach, being able to be fully resected. The reduction of the prevalence of the smoke remains to be the sovereign at the preventions of pulmonary neoplasm and their terrifying after effect. Keywords: Pancoast syndrome; lung cancer; prevalence; mortality; tobacco smoking.

Considerada uma deficiência funcional de ampla complexidade de sistematização dos sintomas e diagnósticos diferenciais, as disfunções temporomandibulares têm maior prevalência no gênero feminino, variando a faixa etária dos 18 aos 45 anos de idade. Pode estar associada a fatores dentários e/ou faciais, os quais se relacionam com o aparelho estomatognático. É imprescindível a anamnese criteriosa e avaliação física amiudada do sistema manducatório (sistema postural que integra músculos mastigatórios e cervicais) – campo multidisciplinar da odontologia, fonoaudiologia, otorrinolaringologia, neurologia e fisioterapia – para adequada propedêutica e assim, correto diagnóstico e precisa abordagem terapêutica do paciente. Este trabalho apresenta um relato de caso de paciente portadora de Disfunção Temporomandibular com alterações cocleares, diagnosticada, conduzida, tratada e evoluída em disciplina clínica de Estomatologia da Universidade do Estado do Amazonas. A problematização do caso, suas resoluções, e o compartilhamento dessas informações corroboram de modo considerável no aspecto clínico e científico, possibilitando ampliar o reconhecimento das diversas situações possíveis no atendimento aos pacientes com este quadro. Assim, as relações profissional-paciente e a multidisciplinaridade dos profissionais envolvidos ganham crescente relevância.Descritores: Orelha Média; Sistema Estomatognático; Dor de Orelha; Cefaleia.ReferênciasMiraglia SS, Nogueira RP, Monazzi MS, Soares FAV. Principais Problemas da ATM. Guia prático de orientação diagnóstica para o clínico geral. Rev Bras Prot Clin Lab. 2001;3(14):271-77.Matta MAP, Honorato DC. Uma abordagem fisioterapêutica nas desordens temporomandibulares: estudo retrospectivo. Fisioter Pesq. 2003;10(2):77-83.Pereira KNF, Andrade LLS, Costa ML, Portal TF. Sinais e sintomas de pacientes com disfunção temporomandibular. Rev CEFAC. 2005;7(2):221-28.Seedorf H, Jude HD. Otalgia as a result of certain temporomandibular joint disorders. Laryngorhinootologie. 2006;85(5):327-32.Costen JB, Louis ST. A syndrome of ear and sinus symptoms dependent upon disturbed function of thetemporomandibular joint 1934. Ann Otol Rhinol Laryngol. 1997;106(10 Pt 1):805-19.Mota LAA, Albuquerque KMG, Santos MHP, Travassos RO. Sinais e sintomas associados à otalgia na disfunção temporomandibular. Arq Int Otorrinolaringol. 2007;11(4):411-15.Pascoal MIN, Abrão R, Chagas JFS, Pascoal MPBN, Claudiney CC, Magna LA. Prevalência dos sintomas otológicos na desordem temperomandibular: estudo de 126 casos. Rev Bras Otorrinolaringol. 2001;67(5):627-33.Sicher H. Temporomandibular articulation in mandibular overclosure. J Am Dent Assoc. 1948;36(2):131-39.Gardner E, Gray DJ, O’Rahilly R, Benevento RH. Anatomia: estudo regional do corpo humano. Rio de Janeiro: Guanabara Koogan; 1978.Myrhaug H. The incidence of ear symptoms in cases of malocclusion and temporomandibular joint disturbancez. Br J Oral Surg. 1964;2(1):28-32.Zocoli R, Mota ME, Sommavilla A, Perin LR. Manifestações otológicas nos distúrbios da articulação temporomandibular. ACM Arq Catarin Med. 2007;36(1):90-95.Ramírez, LM, Ballesteros ALE, Sandoval OGP. A direct anatomical study of the morphology and functionality of disco-malleolar and anterior malleolar ligaments.Int J Morphol. 2009;27(2):367-79.Okeson PJ. Tratamento das desordens temporomandibulares e oclusão. São Paulo: Artes Médicas; 2000.Camparis CM, Formigoni G, Teixeira MJ, de Siqueira JT. Clinical evaluation of tinnitus in patients with sleep bruxism: prevalence and characteristics. J Oral Rehabil. 2005;32(11):808-14.Paiva HJ, Vieira AMF, Cavalcante HCC, Medeiro ME, Gondim NFR, Barbosa RAD. Oclusão: noções e conceitos básicos. São Paulo: Santos;1997.Quinto AC. Classificação e Tratamento das Disfunções Temporomandibulares. Qual o papel do fonoaudiólogo no tratamento dessas disfunções? Rev CEFAC. 2000;2(2):15-22.López-Zuazo A, Sánchez PM.A. Salinas Cubillas Servicio de Neurología. Hospital Universitario de Guadalajara. Guadalajara. España. Medicine. 2015;11:4184-97.Scrivani SJ, Keith DA, Kaban LB. Temporomandibular disorders. N Engl J Med. 2008;359(25):2693-705.Barreto DC, Barbosa ARC, Frizzo ACF. Relação entre disfunção temporomandibular e alterações auditivas. Rev CECAF. 2010;12(6):1067-76.Felício CM, Oliveira JAA, Nunes LJ, Jeronymo LFG, Ferreira-Jeronymo RR. Alterações auditivas relacionadas ao zumbido nos distúrbios otológicos e da articulação temporomandibular. Rev Bras Otorrinolaringol. 1999;65(2):141-46.Jorge JH, Silva Junior GS, Urban VM, Neppelenbroek KH, Bombarda NHC. Desordens temporomandibulares em usuários de prótese parcial removível: prevalência de acordo com a classificação de Kennedy. Rev Odontol UNESP. 2013;42(2):72-7.Fricton J. Myogenous temporomandibular disorders: diagnostic and management considerations. Dent Clin North Am. 2007;51(1):61-83.Feine JS, Widmer CG, Lund JP. Physical therapy: a critique. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;83(1):123-27.Alves Rezende MCR, Marques CB, Gonçales AN, Sales A, Ávila SMHC, Magalhães AP et al. Sinais e sintomas na síndrome de Costen associada a desordens temporomandibulares: relato de caso clínico. Revista Odontol Araçatuba. 2011;32(1):65-9.Garcia AR. Desordens Temporomandibulares. In: Madeira MC. Anatomia da face. São Paulo: Sarvier; 2010.Figueiredo VMG, Cavalcanti AL, Farias ABL e Nascimento SR. Prevalência de sinais, sintomas e fatores associados em portadores de disfunção temporomandibular. Acta Sci Health Sci. 2009;31(2):159-63.Ash CM, Pinto OF. The tmj and the mddle ear: structural and functional correlates for aural symptoms associated with temporomandibular joint dysfunction. Int J Prosthodont. 1991;4(1):51-7.

Responsáveis por amplo e variado quadro de sinais e sintomas de difícil diagnóstico, as desordens da articulação temporomandibular exigem tratamento complexo e multifatorial, já que envolvem ruptura do equilíbrio biomecânico e a forte presença de componentes emocionais. Em razão de etiologia multifatorial (fatores oclusais, alterações esqueléticas, musculares, problemas degenerativos, hábitos nocivos, estresse e/ou problemas emocionais) exige abordagem terapêutica interdisciplinar por vários especialistas (cirurgião dentista, fisioterapeuta, psicólogo e fonaudiólogo)uma vez que a abordagem transdisciplinar e individualizada alicerça o tratamento bem-sucedido.Cada paciente requer procedimentos diferentes em seu tratamento, e é necessário saber em que ponto cada especialista deve intervir para o sucesso da terapêutica. As Desordens temporomandibulares (DTM), relacionadas ao desconforto na articulação temporomandibular (ATM), respondem por importante impacto negativo sobre a qualidade de vida e bem estar. São patologias multifatoriais que exigem diferentes estratégias de abordagem. Cada paciente requer procedimentos diferentes em seu tratamento, e é necessário saber em que ponto cada especialista deve intervir para o sucesso do tratamento.Descritores: Dor Facial; Equipe de Assistência ao Paciente; Sistemas de Saúde.ReferênciasAlves-Rezende MCR, Silva JS, Soares BS, Bertoz FA, Oliveira DTN, Alves-Claro APR. Estudo da prevalência de sintomatologia temporomandibular em universitários brasileiros de Odontologia. Rev Odontol Araçatuba 2009; 30(1): 9-14.Alves-Rezende MCR, Cortiglio S, Sant’anna CBM, Alves-Rezende LGR, Montanher IS, Alves-Rezende ALR. Aplicação da acupuntura no tratamento da Síndrome de Costen: relato de caso clínico. Arch Health Invest 2012; 1(Spec):15.Alves-Rezende MCR, Sant'Anna CBM, Capalbo BC, Zuim PRJ. Intervenção interdisciplinar no tratamento do paciente com dor orofacial: uso de acupuntura. Rev Odontol Unesp 2012; 41: 181Alves-Rezende MCR, Sant'Anna CBM, Verri ACG, Cunha-Correia AS, Aguiar SMHCA, Bertoz APM, et al. Sinais e sintomas na Síndrome de Costen associada a desordens temporomandibulares: relato de caso clínico. Rev Odontol Araçatuba 2011; 32(1):65-9.Alves-Rezende MCR, Soares BMS, Silva JB. Frequência de hábitos parafuncionais: estudo transversal em acadêmicos de Odontologia. Rev Odontol Araçatuba 2009; 30:59-62.Cortiglio S, Alves-Rezende MCR, Alves-Rezende LGR, Montanher IS, Alves-Rezende ALR. Estudo da associação entre bruxismo, consumo de álcool e tabaco em universitários brasileiros Arch Health Invest 2012; 1 (Spec): 36.Koopman JS, Huygen FJ, Dieleman JP, Mos M, Sturkenboom MC. Pharmacological treatment of neuropathic facial pain in the dutch general population. J Pain, 2009; 11(3): 264 –72.Oliveira AS, Bermudez CC, Souza RA, Souza CMF, Dias EM, Castro CES, et al. Impacto da dor na vida de portadores de disfunção temporomandibular. J Appl Oral Sci 2003; 11(2): 138-43.Reisine ST, Fertig J, Weber J, Leder S. Impact of dental conditions on patients’ quality of life. Community Dent Oral Epidemiol 1989; 17(1): 7- 10.Rodrigues D, Siriani AO, Bérzin F. Effect of conventional TENS on pain and electromyographic activity of masticatory muscles in TMD patients. Braz Oral Res 2004;18(4):290-5.Rossi AC, Resende MCRA, Araújo OP Jr, Garcia AR, Zuim PRJ, Marinho LVD. Fisioterapia no tratamento multidisciplinar da disfunção temporomandibular. Rev Odonto UNESP. 2008;37(Número Especial):190Seligman ME, Schulman P, Tryon AM. Group prevention of depression and anxiety symptoms. Behav Res Ther 2007; 45:1111-26.Simi MD, Alves-Rezende MCR, Ruiz MAF, Zuim PRJ. Abordadem extensionista multidisciplinar: fisioterapia aplicada ao tratamento de disfunção temporomandibular. Rev Odontol UNESP. 2012;41(Número Especial):180.Widmer CG. Convicções correntes e diretrizes pedagógicas. In: Lund JP, Lavigne GJ, Dubner R, Sessle BJ. Dor orofacial: da ciência básica à conduta clínica. São Paulo: Quintenssence Books: 2002. p. 27-34.Granja DVA, Lima AP. Influência dos recursos fisioterapêuticos nas algias orofaciais. Rev Fisioter Brasil 2003;4(6):394-401.Pereira Jr FJ, Vieira AR, Prado R, Miasato JM. Visão geral das desordens temporomandibulares. RGO 2004;52(2):117-21.Barbosa GAS, Barbosa KVMS, Badaró CR Filho. Recursos fisioterápicos disponíveis para o tratamento das disfunções temporomandibulares. JBA 2003; 3(11):257-62.Castro FM, Gomes RCV, Salomão JR, Abdon APV. A efetividade da terapia de liberação posicional (TLP) em pacientes portadores de disfunção temporomandibular. Rev Odont Univ Cidade São Paulo. 2006; 18(1):67-74.Maciel RN. Oclusão e ATM: procedimentos clínicos. São Paulo: Ed. Santos; 1998. Maluf SA, Moreno BGD, Alfredo PP. Exercícios terapêuticos nas desordens temporomandibulares: uma revisão de literatura. Fisioter Pesq. 2008; 15(4): 408-15.Medlicott MS, Harris SR. A systematic review of the effectiveness of exercise, manual therapy, electrotherapy, relaxation training, and biofeedback in the management of temporomandibular disorder. Physical Ther 2006; 86(7):955-73.Torres F, Campos LG, Fillipini HF, Weigert KL, Dalla Vecchia GF. Efeitos dos tratamentos fisioterapêutico e odontológico em pacientes com disfunção temporomandibular Fisioter Mov 2012; 25(1):117-25Teixeira MJ, Teixeira WGJ, Santos FPSS, Andrade DCA, Bezerra SL, Figueirdo JB, et al. Epidemiologia clínica da dor músculo-esquelética. Rev Med 2001; 80(1): 1-21.Melzack R. The McGill pain questionnaire. From description to measurement. Anesthes 2005; 103(1):199-202Chaves TC, Oliveira AS, Grossi DB. Principais instrumentos para avaliação da disfunção temporomandibular, parte I: índices e questionários; uma contribuição para a prática clínica e de pesquisa. Fisioter Pesq. 2008;15(1):92-100El Fatih I A, Ibrahim AI, El Laithi A. Efficacy of physiotherapy and intraoral splint in the management of temporomandibular disorders. Saud Dent J 2004;16(1):16-20.Guerra LMC. Eficácia do ultra-som na terapia das Disfunções Temporomandibulares: avaliação clínica e eletromiográfica. [dissertação]. Pernambuco: Universidade Federal de Pernambuco; 2003.Biasotto DA. Efeito da técnica Fisioterapeutica (massoterapia) em indivíduos portadores de Desordem Temporomandibular Miogênica: um estudo eletromiográfico. [dissertação]. Piracicaba: Faculdade de Odontologia de Piracicaba da Universidade Estadual de Campinas; 2002.Eisensmith LP. Massage therapy decreases frequency and intensity of symptoms related to temporomandibular joint syndrome in one case study. J Bodywork Move Therap 2007;11:223-30.Chaitow L. Teoria e prática da manipulação craniana: abordagens em tecidos ossos e mole. São Paulo: Manole, 2001.Troian MA. Tratamento interdisciplinar entre fisioterapia e odontologia na redução da dor em pacientes com disfunção do sistema craniocervicomandibular. Reabilit. 2005;7(26):29-39.Mourão NLA, Mesquita VT. A Importância da fisioterapia no tratamento das disfunções da Atm. Terapia Manual. 2006;4:66-9.

Bruxism is the harmful habit of clenching or grinding the teeth during the day and / or night, with unconscious pattern, with particular intensity and frequency, outside the functional movements of chewing and swallowing. It is accepted that bruxism is a response controlled by the neurotransmitters dopamine system associated with emotional component. The proposed of treatment of bruxism with acupuncture aims to stimulate sensory fibers of the peripheral nervous system leading to electrical transmission by neurons sufficient to produce changes in the central nervous system. As a consequence there is the release of substances (cortisol, endorphins, dopamine, noradrenaline and serotonin) that promote wellness and restoration of harmony, be it psychological, biological and / or behavioral.Descriptors: Acupuncture Therapy; Acupuncture Points; Temporomandibular Joint Disorders .ReferencesAlves-Rezende MCR, Silveira BASV, Bertoz APM, Dekon SFC, Verri ACG, Alves-Rezende LGR, et al. Parafunctional activities in brazilian children and adolescent. Rev Odontol Araçatuba. 2011; 32: 62-6.Alves-Rezende MCR, Soares BMS, Silva JS, Goiato MC, Turcio KHL, Zuim PRJ, et al. Frequência de hábitos parafuncionais: estudo transversal em acadêmicos de Odontologia. Rev Odontol Araçatuba. 2009; 30: 59-62.Alves-Rezende MCR, Silva JS, Soares BMS, Bertoz FA, Oliveira DTN, Alves-Claro APR. Estudo da prevalência de sintomatologia temporomandibular em universitários brasileiros de Odontologia. Rev Odontol Araçatuba. 2009; 30: 9-14.Cortiglio S, Alves-Rezende MCR, Alves-Rezende LGR, Montanher IS, Alves-Rezende ALR. Estudo da associação entre bruxismo, consumo de álcool e tabaco em universitários brasileiros. Arch Health Invest. 2012; 1 (Spec):36Alves-Rezende MCR, Bertoz APM, Aguiar SMHCA, Alves-Rezende LGR, Alves-Rezende ALR, Montanher IS, et al. Abordagem terapêutica nas desordens temporomandibulares: técnicas de fisioterapia associadas ao tratamento odontológico. Arch Health Invest. 2012; 1: 18-23Tomé MC, Farret MMB, Jurach EM. Hábitos orais e maloclusão. In: Marchesan, I. Tópicos em fonoaudiologia. São Paulo: Lovise; 1996. p.97-109.Okeson JP. Tratamento das desordens temporomandibulares e oclusão. 4. ed. São Paulo: Artes Médicas; 2000.Cerqueira JAO, Borel KC, Coelho KCC, Barbosa FS, Silva VCC. Prevalência de hábitos parafuncionais em universitários. Rev Cient FAMINAS. 2007; 1:223.Friedman J. Mascar chicletes pode causar danos à mandíbula. Jornal do Comércio, Recife, 13 de julho de 1997. Disponível em: <http:// www2.uol.com.br/ JC/1507 /fa1307d.htm>. Acesso em: 22 out 2012.Gavish A, Halachmi M, Winocur E, Gazit E. Oral habits and their association with signs and symptoms of temporomandibular disorders in adolescent girls. J Oral Rehabil. 2000; 27: 22-32.Kampe T, Tagdae T, Bader G, Edman G, Karlsson S. Reported symptoms and clinical findings in a group of subjects with longstanding bruxing behaviour. J Oral Rehabil. 1997; 24:581–7Lavigne GJ, Rompré PH, Montplaisir JY. Sleep bruxism: validity of clinical research diagnostic criteria in a controlled polysomnographic study. J Dent Res. 1996;75:546-52.MacFarlane TV, Blinkhorn AS, Davies RM, Worthington HV. Association between local mechanical factors and orofacial pain: survey in the community. J Dent. 2003; 31(8): 535-42.Thompson BA, Blount BW, Krumholz TS. Treatment approaches to bruxism. Am FamPhysician. 1994; 49:1617–22.Bianchini EMG. Mastigação e ATM. In: Marchesan IQ. Fundamentos em fonoaudiologia: aspectos clínicos da motricidade oral. Rio de Janeiro: Guanabara Koogan; 1998. p.37-49.Dawson PE. Avaliação, diagnóstico e tratamento dos problemas oclusais. 2.ed. Porto Alegre: Artes Médicas; 1993.Durso BC, Azevedo LR, Ferreira JTL. Inter-relação ortodontia x disfunção da articulação temporomandibular. J Bras Ortodon Ortop Facial. 2002; 7: 155-60.Lavigne GJ, Lobbezoo F, Rompré PH, Nielsen TA, Montplaisir J. Cigarette smoking as a risk factor or an exacerbating factor for restless legs syndrome and sleep bruxism. Sleep. 1997; 20:290-3.Alves-Rezende MCR, Bertoz APM, Dekon SFC, Alves-Rezende LGR, Alves-Rezende ALR, Montanher IS, et al. Association between bruxism, alcoholand tobacco use among brazilian students. Rev Odontol Araçatuba. 2011; 32:18-22Cuccia AM. Aetiology of sleep bruxism: a review of the literature. Recenti Progress Med. 2008, 99:322-8.21. Clark GT, Tsukiyama Y, Baba K, Watanabe T. Sixty-eight years of experimental occlusal interference studies: what have we learned? J Prosthet Dent. 1999; 82:704-13Major M, Rompré PH, Guitard F, Tenbokum L, O'Connor K, Nielsen T, et al. A controlled daytime challenge of motor performance and vigilance in sleep bruxers. J Dent Res. 1999; 78:1754-62.Thie NM, Kato T, Bader G, Montplaisir JY, Lavigne GJ. The significance of saliva during sleep and the relevance of oromotor movements. Sleep Med Rev. 2002; 6:213-27.Malta DC, Porto DL, Melo FCM, Monteiro RA, Sardinha LMV, Lessa BH. Family and the protection from use of tobacco, alcohol, and drugs in adolescents, National School Health Survey. Rev Bras Epidemiol. 2011; 14:166-77.Molina OF, dos Santos Jr J. Hostility in TMD/ bruxism patients and controls: a clinical comparison study and preliminary results. Cranio. 2002; 20:282-8.Lavigne GJ, Kato T, Kolta A, Sessle BJ. Neurobiological mechanisms involved in sleep bruxism. Crit Rev Oral Biol Med. 2003;14:30-46.Ohayon MM, Li KK, Guilleminault C. Risk factors for sleep bruxism in the general population. Chest. 2001; 119:53-61.Schneider C, Schaefer R, Ommerborn MA, GirakiM, Goertz A, Raab WH, et al. Maladaptive coping strategies in patients with bruxism compared to non-bruxing controls. Int J Behav Med. 2007; 14:257-61Lavigne GJ, Manzini C, Kato T. Sleep bruxism. In: Kryger MH, Roth T, Dement WC, editors. Principles and practice of sleep medicine. 4th. ed. Philadelphia: Elsevier Saunders; 2005. p. 946-59.Reding GR, Rubright WC, Zimmerman SO. Incidence of bruxism. J Dent Res. 1966; 45:1198–204Glaros AG. Incidence of diurnal and nocturnal bruxism. J Prosthet Dent. 1981; 45:545–9Lavigne GJ, Montplaisir J. Restless legs syndrome and sleep bruxism: prevalence and association among Canadians. Sleep. 1994; 17:739–43Ohayon MM, Li KK, Guilleminault C. Risk factors for sleep bruxism in the general population. Chest. 2001; 119:53–61.Laberge L, Tremblay RE, Vitaro F, Montplaisir J. Development of parasomnias from childhood to early adolescence. Pediatrics. 2000; 106:67–74.Rugh JD, Harlan J. Nocturnal bruxism and temporomandibular disorders. In: Jankovic J, Tolosa E, editors. Advances in neurology. New York: Raven Press; 1988. p. 329-41.Lavigne GJ, Manzini C. Sleep bruxism and concomitant motor activity. In: Kryger, Roth, D. ed. Principles and practice of sleep medicine. Philadelphia: W.B. Saunders; 2000. p. 773-85.Lavigne GJ, Guitard F, Rompré PH, Montplaisir JY. Variability in sleep bruxism activity over time. J Sleep Res. 2001; 103:237–44.Bader G, Lavigne GJ. Sleep bruxism: overview of an oromandibular sleep movement disorder. Sleep Med Rev. 2000; 4:27–43Lavigne GJ, Rompré PH, Montplaisir J. Sleep bruxism: validity of clinical research diagnostic criteria in a controlled polysomnographic study. J Dent Res. 1996; 75:546–52.Rugh JD, Harlan J. Nocturnal bruxism and temporomandibular disorders. Advances Neurol. 1988; 49:329-41.Você marcou isto com +1 publicamente.Ikeda T, Nishigawa K, Kondo K, Takeuchi H, Clark GT. Criteria for the detection of sleep-associated bruxism in humans. J Orofac Pain. 1996; 10:270–82Gallo LM, Lavigne GJ, Rompré PH Reliability of scoring EMG orofacial events: polysomnography compared ambulatory recordings. J Sleep Res. 1997; 6:259–63Velly-Miguel AM, Montplaisir J, Rompré PH, Lund JP, Lavigne GJ. Bruxism and other orofacial movements during sleep. J Craniomandib Disord Fac Oral Pain. 1992; 6:71–81Kato T, Montplaisir J, Blanchet P, Lund JP, Lavigne GJ. Idiopathic myoclonus in the oromandibular region during sleep: a possible source of confusion in sleep bruxism diagnosis. Mov Disord. 1999;14:865–71Ware JC, Rugh JD. Destructive bruxism: sleep stage relationship. Sleep. 1988; 11:172–81.Macaluso GM, Guerra P, Di Giovanni G, Boselli M, Parrino L, Terzano MG. Sleep bruxism is a disorder related to periodic arousals during sleep. J Dent Res. 1998; 77:565–73.Saber M, Guitard F, Rompré PH, Montplaisir J, Lavigne GJ. Distribution of rhythmic masticatory muscle activity across sleep stages and association with sleep stage shifts (abstract). J Dent Res. 2002; 81(Spec Iss A):297Gastaut H, Batini C, Broughton R, Fressy J, Tassinari CA. Étude électroencéphalographique des phénomènes épisodiques non épileptiques au cours du sommeil. In: Le sommeil de nuit normal et pathologique. Paris: Masson, Cie; 1965.Halász P, Ujszaszi J, Gadoros J. Are microarousals preceded by electroencephalographic slow wave synchronization precursors of confusional awakenings? Sleep. 1985; 8:231–8Lavigne GJ, Rompré PH, Poirier G, Huard H, Kato T, Montplaisir JY. Rhythmic masticatory muscle activity during sleep in humans. J Dent Res. 2001; 80:443–8Alves-Rezende MCR, Bertoz APM, Aguiar SMHCA, Alves-Rezende LGR, Alves-Rezende ALR, Montanher IS, et al. Abordagem terapêutica nas desordens temporomandibulares: técnicas de fisioterapia associadas ao tratamento odontológico. Arch Health Invest. 2012; 1: 18-23Alves-Rezende MCR, Silva JS, Soares BMS, Bertoz FA, Oliveira DTN, Alves-Claro APR. Estudo da prevalência de sintomatologia temporomandibular em universitários brasileiros de Odontologia. Rev Odontol Araçatuba. 2009; 30: 9-14.Alves-Rezende MCR Cortiglio S, Sant’Anna CBM, Alves-Rezende LGR, Montanher IS, Alves-Rezende ALR. Aplicação da acupuntura no tratamento da síndrome de Costen: relato de caso clínico. Arch Health Invest. 2012; 1(Spec): 15Cortiglio S, Alves-Rezende MCR, Alves-Rezende LGR, Montanher IS, Alves-Rezende ALR. Estudo da associação entre bruxismo, consumo de álcool e tabaco em universitários brasileiros Arch Health Invest. 2012; 1 (Spec): 36.Dallanora LJ, Faltin PP, Inoue RT, Santos VM. Avaliação do uso de acupuntura no tratamento de pacientes com bruxismo. RGO. 2004; 52(5):333-39.Maciocia G. Obstetrícia & ginecologia em medicina chinesa. 10.ed. São Paulo: Roca; 2000.Junying G, Zhihong S. Medicina tradicional chinesa prática e farmacologia: teoria e princípios básicos. São Paulo: Roca; 1996.Yamamura Y. Tratado de medicina chinesa. Trad. Xi Wenbu, Beijing, China. Roca: São Paulo; 1993.Hoppenfeld S. Propedêutica ortopédica: coluna e extremidades. Atheneu: São Paulo;1996.Sussmann D. Acupuntura: teoria y práctica. Buenos Aires: Kier; 2000.Rosted P. Introduction to acupuncture in dentistry. Br Dent J. 2000; 189:136-40Quaggio AM. Carvalho PSM, Santos JFF, Marchini L. A utilização da acupuntura em desordens craniomandibulares. J Bras Oclusão ATM Dor Orofac. 2002; 2: 334-7.Ding L. Acupuntura: teoria do meridiano e pontos de acupuntura. São Paulo: Roca; 1996.Ross J. Combinações dos pontos de acupuntura: a chave para o êxito clínico. São Paulo: Roca, 2003.Wen TS. Acupuntura clássica chinesa. São Paulo: Cultrix; 1985.