<div id="pf1" class="pf w0 h0" data-page-no="1"><div class="pc pc1 w0 h0"><img class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/379a7711-6274-4602-a98e-2ca884fa22a2/bg1.png"><div class="t m0 x0 h2 y1 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 y2 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 y3 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 y4 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 y5 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 y6 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 y7 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 y8 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 y9 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 ya ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 yb ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 yc ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 yd ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 ye ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 yf ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x1 h2 y10 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x1 h2 y11 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 y12 ff1 fs0 fc0 sc0 ls0 ws1">A <span class="blank _0"></span>A<span class="blank _1"></span>TM é considerada a ar<span class="blank _0"></span>ticulação mais complexa do corpo humano,<span class="blank _0"></span> já que permite a re<span class="blank _0"></span>alização </div><div class="t m0 x0 h2 y13 ff1 fs0 fc0 sc0 ls0 ws1">de movimentos rotacionais e tr<span class="blank _0"></span>anslacionais,<span class="blank _0"></span> além de deslizamentos, nos casos dos movimentos de </div><div class="t m0 x0 h2 y14 ff1 fs0 fc0 sc0 ls0 ws1">later<span class="blank _0"></span>alidade. </div><div class="t m0 x0 h2 y15 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h3 y16 ff2 fs0 fc1 sc0 ls0 ws1">Disco Ar<span class="blank _0"></span>ticular<span class="ff3 fc0"> </span></div><div class="t m0 x2 h2 y17 ff1 fs0 fc0 sc0 ls0 ws1">Se encontra entr<span class="blank _0"></span>e o côndilo e a eminência articular <span class="blank _2"></span><span class="ff4">\u2022</span></div><div class="t m0 x2 h2 y18 ff1 fs0 fc0 sc0 ls0 ws1">Divide a articulação em cavidades inferior e superior <span class="blank _3"></span><span class="ff4">\u2022</span></div><div class="t m0 x2 h2 y19 ff1 fs0 fc0 sc0 ls0 ws1">Estabiliza os movimentos <span class="blank _4"></span><span class="ff4">\u2022</span></div><div class="t m0 x2 h2 y1a ff1 fs0 fc0 sc0 ls0 ws1">Amortece os choques dur<span class="blank _0"></span>ante a movimentação <span class="blank _5"></span><span class="ff4">\u2022</span></div><div class="t m0 x2 h2 y1b ff1 fs0 fc0 sc0 ls0 ws1">Não é inervado nem vascularizado (logo,<span class="blank _1"></span> qualquer alteração no disco não será r<span class="blank _0"></span>egenerada) <span class="blank _6"></span><span class="ff4">\u2022</span></div><div class="t m0 x0 h2 y1c ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 y1d ff2 fs0 fc1 sc0 ls0 ws1">Músculos da Mastigação<span class="ff3 fc0"> <span class="ff1"> </span></span></div><div class="t m0 x2 h2 y1e ff1 fs0 fc0 sc0 ls0 ws1">M.<span class="blank _0"></span> Masseter: Elevação da mandíbula <span class="blank _7"></span><span class="ff4">\u2022</span></div><div class="t m0 x2 h2 y1f ff1 fs0 fc0 sc0 ls0 ws1">M.<span class="blank _0"></span> T<span class="blank _8"></span>emporal: Elevação<span class="blank _0"></span>, posicionamento e r<span class="blank _0"></span>etrusão da mandíbula <span class="blank _9"></span><span class="ff4">\u2022</span></div><div class="t m0 x2 h2 y20 ff1 fs0 fc0 sc0 ls0 ws1">M.<span class="blank _0"></span> Pterigoide Medial: Elevação e protrusão da mandíbula <span class="blank _a"></span><span class="ff4">\u2022</span></div><div class="t m0 x2 h2 y21 ff1 fs0 fc0 sc0 ls0 ws1">M.<span class="blank _0"></span> Pterigoide Lateral: <span class="blank _b"></span><span class="ff4">\u2022</span></div><div class="t m0 x3 h2 y22 ff1 fs0 fc0 sc0 ls0 ws1">Superior: Elevação da mandíbula <span class="blank _c"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y23 ff1 fs0 fc0 sc0 ls0 ws1">Inferior: Aber<span class="blank _0"></span>tura e pr<span class="blank _0"></span>otrusão da mandíbula <span class="blank _d"></span><span class="ff5">\u25e6</span></div><div class="t m0 x0 h2 y24 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h3 y25 ff2 fs0 fc1 sc0 ls0 ws1">Biomecânica da A<span class="blank _1"></span>TM<span class="ff6 fc0"> </span></div><div class="t m0 x0 h2 y26 ff7 fs0 fc0 sc0 ls0 ws0">Rotação<span class="ff1 ws1">: Ocorr<span class="blank _0"></span>e entre o disco e o côndilo (por<span class="blank _0"></span>ção inferior da articulação) </span></div><div class="t m0 x0 h2 y27 ff7 fs0 fc0 sc0 ls0 ws0">T<span class="blank _e"></span>ranslação<span class="ff1 ws1">: Ocorr<span class="blank _0"></span>e entre o disco e a eminência ar<span class="blank _0"></span>ticular (porção superior da articulação) </span></div><div class="t m0 x0 h2 y28 ff7 fs0 fc0 sc0 ls0 ws1">Abertur<span class="blank _0"></span>a e F<span class="blank _0"></span>echamento<span class="ff1">: Movimentos de rotação<span class="blank _0"></span>,<span class="blank _0"></span> em ambas as A<span class="blank _1"></span>TMs </span></div><div class="t m0 x0 h2 y29 ff7 fs0 fc0 sc0 ls0 ws1">P<span class="blank _1"></span>rotrusão e Retrusão<span class="ff1">: Movimentos de r<span class="blank _0"></span>otação,<span class="blank _1"></span> em ambas as A<span class="blank _1"></span>TMs </span></div><div class="t m0 x0 h2 y2a ff7 fs0 fc0 sc0 ls0 ws0">Later<span class="blank _0"></span>alidade<span class="ff1 ws1">: No lado para o qual a mandíbula se movimenta,<span class="blank _0"></span> a A<span class="blank _1"></span>TM ir<span class="blank _0"></span>á apresentar movimentos </span></div><div class="t m0 x0 h2 y2b ff1 fs0 fc0 sc0 ls0 ws1">de rotação<span class="blank _0"></span>,<span class="blank _0"></span> enquanto que o lado oposto irá apresentar movimentos de tr<span class="blank _0"></span>anslação </div><div class="t m0 x0 h2 y2c ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x4 h4 y2d ff8 fs1 fc0 sc0 ls0 ws1">Eminência </div><div class="t m0 x5 h4 y2e ff8 fs1 fc0 sc0 ls0 ws1">articular </div><div class="t m0 x6 h5 y2f ff8 fs2 fc0 sc0 ls0 ws1">Boca aberta</div><div class="t m0 x7 h4 y30 ff8 fs1 fc0 sc0 ls0 ws1">Côndilo da </div><div class="t m0 x7 h4 y31 ff8 fs1 fc0 sc0 ls0 ws1">Mandíbula </div><div class="t m0 x8 h6 y32 ff8 fs3 fc0 sc0 ls0 ws1">A <span class="blank _0"></span>A<span class="blank _1"></span>TM é formada pelas estruturas: </div><div class="t m0 x9 h6 y33 ff8 fs3 fc0 sc0 ls0 ws1">Côndilo da mandíbula <span class="blank _f"></span><span class="ff4">\u2022</span></div><div class="t m0 x9 h6 y34 ff8 fs3 fc0 sc0 ls0 ws1">Eminência articular (osso tempor<span class="blank _0"></span>al) <span class="blank _10"></span><span class="ff4">\u2022</span></div><div class="t m0 x9 h6 y35 ff8 fs3 fc0 sc0 ls0 ws1">Disco articular <span class="blank _11"></span><span class="ff4">\u2022</span></div><div class="t m0 x9 h6 y36 ff8 fs3 fc0 sc0 ls0 ws1">Ligamentos discais <span class="blank _12"></span><span class="ff4">\u2022</span></div><div class="t m0 x9 h6 y37 ff8 fs3 fc0 sc0 ls0 ws1">Ligamento posterior <span class="blank _13"></span><span class="ff4">\u2022</span></div><div class="t m0 x9 h6 y38 ff8 fs3 fc0 sc0 ls0 ws1">Cápsula ar<span class="blank _0"></span>ticular <span class="blank _14"></span><span class="ff4">\u2022</span></div><div class="t m0 x9 h6 y39 ff8 fs3 fc0 sc0 ls0 ws1">Ligamentos temporomandibular<span class="blank _0"></span>es <span class="blank _15"></span><span class="ff4">\u2022</span></div><div class="t m0 x9 h6 y3a ff8 fs3 fc0 sc0 ls0 ws1">V<span class="blank _0"></span>asos sanguíneos e nervos <span class="blank _16"></span><span class="ff4">\u2022</span></div><div class="t m0 x9 h6 y3b ff8 fs3 fc0 sc0 ls0 ws1">Músculos mastigatórios<span class="blank _f"></span><span class="ff4">\u2022</span></div><div class="t m0 xa h5 y2f ff8 fs2 fc0 sc0 ls0 ws1">Boca fechada</div><div class="t m0 xb h5 y3c ff8 fs2 fc0 sc0 ls0 ws1">Disco articular </div><div class="t m0 xb h5 y3d ff8 fs2 fc0 sc0 ls0 ws1">Ligamentos </div><div class="t m0 xb h5 y3e ff8 fs2 fc0 sc0 ls0 ws1">Inserção </div><div class="t m0 xb h5 y3f ff8 fs2 fc0 sc0 ls0">muscular</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf2" class="pf w0 h0" data-page-no="2"><div class="pc pc2 w0 h0"><img class="bi xc y40 w2 h7" alt="" src="https://files.passeidireto.com/379a7711-6274-4602-a98e-2ca884fa22a2/bg2.png"><div class="t m0 x0 h2 y1 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h8 y41 ff2 fs4 fc2 sc0 ls0 ws1">DESORDENS <span class="blank _0"></span>TEMPOROMANDIBULARES<span class="fs0"> </span></div><div class="t m0 x2 h2 y42 ff1 fs0 fc0 sc0 ls0 ws1">Grupo heterogêneo de condições que afetam as ar<span class="blank _0"></span>ticulações temporomandibular<span class="blank _0"></span>es,<span class="blank _0"></span> a <span class="blank _17"></span><span class="ff4">\u2022</span></div><div class="t m0 x2 h2 y43 ff1 fs0 fc0 sc0 ls0 ws1">musculatur<span class="blank _0"></span>a mastigatória e estruturas associadas </div><div class="t m0 x2 h2 y44 ff1 fs0 fc0 sc0 ls0 ws1">P<span class="blank _e"></span>odem causar diversas queixas nos pacientes: <span class="blank _18"></span><span class="ff4">\u2022</span></div><div class="t m0 x3 h2 y45 ff1 fs0 fc0 sc0 ls0 ws1">Dor na musculatur<span class="blank _0"></span>a mastigatória e na A<span class="blank _e"></span>TM <span class="blank _19"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y46 ff1 fs0 fc0 sc0 ls0 ws1">Dor acentuada durante a mastigação <span class="blank _1a"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y47 ff1 fs0 fc0 sc0 ls0 ws1">Limitação e assimetria da abertur<span class="blank _0"></span>a bucal <span class="blank _1b"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y48 ff1 fs0 fc0 sc0 ls0 ws1">P<span class="blank _1"></span>resença de ruídos na <span class="blank _0"></span>A<span class="blank _1"></span>TM <span class="blank _1c"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y49 ff1 fs0 fc0 sc0 ls0 ws1">Dor mandibular <span class="blank _1d"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y4a ff1 fs0 fc0 sc0 ls0 ws1">Dor de ouvido <span class="blank _1e"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y4b ff1 fs0 fc0 sc0 ls0 ws1">Dor de cabeça <span class="blank _1f"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y4c ff1 fs0 fc0 sc0 ls0 ws1">Dor facial <span class="blank _20"></span><span class="ff5">\u25e6</span></div><div class="t m0 x0 h2 y4d ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 y4e ff2 fs0 fc1 sc0 ls0 ws1">F<span class="blank _1"></span>atores C<span class="blank _0"></span>ontribuintes<span class="ff3 fc0"> <span class="ff1">(podem <span class="ff9 ws0">in\ufb02uenciar</span> o resultado do tr<span class="blank _0"></span>atamento) </span></span></div><div class="t m0 x2 h2 y4f ff1 fs0 fc0 sc0 ls0 ws1">F<span class="blank _1"></span>atores P<span class="blank _1"></span>r<span class="blank _0"></span>edisponentes <span class="blank _21"></span><span class="ff4">\u2022</span></div><div class="t m0 x3 h2 y50 ff1 fs0 fc0 sc0 ls0 ws1">Aumentam o risco de desenvolvimento da D<span class="blank _0"></span>TM <span class="blank _22"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y51 ff1 fs0 fc0 sc0 ls0 ws1">P<span class="blank _e"></span>odem ser fatores genéticos ou psicológicos <span class="blank _23"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y52 ff1 fs0 fc0 sc0 ls0 ws1">Condições sistêmicas,<span class="blank _1"></span> como desordens reumá<span class="blank _0"></span>ticas,<span class="blank _0"></span> hormonais, infeccionais,<span class="blank _1"></span> nutricionais e <span class="blank _24"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y53 ff1 fs0 fc0 sc0 ls0 ws1">metabólicas,<span class="blank _0"></span> que afetam a mastigação e elevar a tensão muscular </div><div class="t m0 x3 h2 y54 ff1 fs0 fc0 sc0 ls0 ws1">T<span class="blank _8"></span>ambém podem ser fatores biomecânicos,<span class="blank _0"></span> como lesões que ocorr<span class="blank _0"></span>eram no passado,<span class="blank _0"></span> <span class="blank _25"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y55 ff1 fs0 fc0 sc0 ls0 ws1">problemas esqueléticos,<span class="blank _1"></span> desequilíbrio postural,<span class="blank _0"></span> colapso de oclusão (ausência dentária,<span class="blank _0"></span> </div><div class="t m0 x3 h2 y56 ff1 fs0 fc0 sc0 ls0 ws1">mordida cruzada etc) </div><div class="t m0 x0 h2 y57 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x2 h2 y58 ff1 fs0 fc0 sc0 ls0 ws1">F<span class="blank _1"></span>atores Iniciantes (causam o início da desor<span class="blank _0"></span>dem) <span class="blank _26"></span><span class="ff4">\u2022</span></div><div class="t m0 x3 h2 y59 ff1 fs0 fc0 sc0 ls0 ws1">Macrotr<span class="blank _0"></span>auma (resultado de um único evento) <span class="blank _27"></span><span class="ff5">\u25e6</span></div><div class="t m0 xd h2 y5a ff1 fs0 fc0 sc0 ls0 ws1">Extrínseco (<span class="ff9">fonte externa</span>) <span class="blank _28"></span><span class="ffa">\u2023</span></div><div class="t m0 xe h2 y5b ff1 fs0 fc0 sc0 ls0 ws1">Lesão por impacto dir<span class="blank _0"></span>eto durante acidentes <span class="blank _29"></span><span class="ff4">\u2022</span></div><div class="t m0 xe h2 y5c ff1 fs0 fc0 sc0 ls0 ws1">Acidente automobilístico ou esportes de conta<span class="blank _0"></span>to <span class="blank _2a"></span><span class="ff4">\u2022</span></div><div class="t m0 xd h2 y5d ff1 fs0 fc0 sc0 ls0 ws1">Intrínseco (<span class="ff9">fonte interna</span>) <span class="blank _2b"></span><span class="ffa">\u2023</span></div><div class="t m0 xe h2 y5e ff1 fs0 fc0 sc0 ls0 ws1">Mastigação de alimentos duros <span class="blank _2c"></span><span class="ff4">\u2022</span></div><div class="t m0 xe h2 y5f ff1 fs0 fc0 sc0 ls0 ws1">Bocejar \u201c<span class="blank _1"></span>de mal jeito\u201d ou manter a boca aberta por um longo período <span class="blank _2d"></span><span class="ff4">\u2022</span></div><div class="t m0 xe h2 y60 ff1 fs0 fc0 sc0 ls0 ws1">Intubação para anestesia ger<span class="blank _0"></span>al <span class="blank _2e"></span><span class="ff4">\u2022</span></div><div class="t m0 x3 h2 y61 ff1 fs0 fc0 sc0 ls0 ws1">Microtr<span class="blank _0"></span>auma (cargas adversas r<span class="blank _0"></span>epetidas sobre o sistema mastiga<span class="blank _0"></span>tório) <span class="blank _2f"></span><span class="ff5">\u25e6</span></div><div class="t m0 xd h2 y62 ff1 fs0 fc0 sc0 ls0 ws1">Hábitos parafuncionais,<span class="blank _1"></span> como bruxismo e apartamento dental <span class="blank _30"></span><span class="ffa">\u2023</span></div><div class="t m0 x0 h2 y63 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 y64 ff3 fs0 fc0 sc0 ls0 ws0">Lembr<span class="blank _0"></span>ete:<span class="ff1 ws1"> O Bruxismo não é uma D<span class="blank _0"></span>TM,<span class="blank _0"></span> mas sim uma entidade a parte,<span class="blank _0"></span> uma parafunção.<span class="blank _1"></span> P<span class="blank _1"></span>orém,<span class="blank _1"></span> </span></div><div class="t m0 x0 h2 y65 ff1 fs0 fc0 sc0 ls0 ws1">na sua presença,<span class="blank _1"></span> ele é um fator contribuinte que pode iniciar uma D<span class="blank _0"></span>TM,<span class="blank _0"></span> pode complicar o </div><div class="t m0 x0 h2 y66 ff1 fs0 fc0 sc0 ls0 ws1">tra<span class="blank _0"></span>tamento desta e também pode perpetuar a desordem.<span class="blank _0"></span> </div><div class="t m0 x0 h2 y67 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x2 h2 y68 ff1 fs0 fc0 sc0 ls0 ws1">F<span class="blank _1"></span>atores P<span class="blank _e"></span>erpetuantes <span class="blank _31"></span><span class="ff4">\u2022</span></div><div class="t m0 x3 h2 y69 ff1 fs0 fc0 sc0 ls0 ws1">Interferem e complicam o tr<span class="blank _0"></span>atamento <span class="blank _32"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y6a ff1 fs0 fc0 sc0 ls0 ws1">P<span class="blank _e"></span>odem ser: <span class="blank _33"></span><span class="ff5">\u25e6</span></div><div class="t m0 xd h2 y6b ff1 fs0 fc0 sc0 ls0 ws1">F<span class="blank _1"></span>atores de personalidade <span class="blank _34"></span><span class="ffa">\u2023</span></div><div class="t m0 xd h2 y6c ff1 fs0 fc0 sc0 ls0 ws1">F<span class="blank _1"></span>atores sociais <span class="blank _1e"></span><span class="ffa">\u2023</span></div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf3" class="pf w0 h0" data-page-no="3"><div class="pc pc3 w0 h0"><div class="t m0 xd h2 y1 ff1 fs0 fc0 sc0 ls0 ws1">F<span class="blank _1"></span>atores emocionais e cognitivos <span class="blank _10"></span><span class="ffa">\u2023</span></div><div class="t m0 xe h2 y2 ff1 fs0 fc0 sc0 ls0 ws1">Di\ufb01culdade de lidar com atividades normais <span class="blank _35"></span><span class="ff4">\u2022</span></div><div class="t m0 xe h2 y3 ff1 fs0 fc0 sc0 ls0 ws1">Estresse,<span class="blank _1"></span> ansiedade, pensamentos nega<span class="blank _0"></span>tivos <span class="blank _36"></span><span class="ff4">\u2022</span></div><div class="t m0 xe h2 y4 ff1 fs0 fc0 sc0 ls0 ws1">Outros <span class="blank _37"></span><span class="ff4">\u2022</span></div><div class="t m0 xd h2 y5 ff1 fs0 fc0 sc0 ls0 ws1">Distúrbios do sono <span class="blank _38"></span><span class="ffa">\u2023</span></div><div class="t m0 x0 h2 y6 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 y7 ff2 fs0 fc1 sc0 ls0 ws1">Ruídos da <span class="blank _0"></span>A<span class="blank _1"></span>TM<span class="ff1 fc0"> </span></div><div class="t m0 x2 h2 y8 ff1 fs0 fc0 sc0 ls0 ws1">\u201cClick\u201d <span class="blank _39"></span><span class="ff4">\u2022</span></div><div class="t m0 x3 h2 y9 ff1 fs0 fc0 sc0 ls0 ws1">Som de curta dur<span class="blank _0"></span>ação que pode ocorrer em qualquer momento durante a aber<span class="blank _0"></span>tura <span class="blank _3a"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 ya ff1 fs0 fc0 sc0 ls0 ws1">mandibular </div><div class="t m0 x3 h2 yb ff1 fs0 fc0 sc0 ls0 ws1">Repr<span class="blank _0"></span>esenta a passagem do côndilo sob o bordo posterior do disco ar<span class="blank _0"></span>ticular <span class="blank _3b"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 yc ff1 fs0 fc0 sc0 ls0 ws1">O dentista pode não ouvir<span class="blank _1"></span>, mas o paciente escuta <span class="blank _3c"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 yd ff1 fs0 fc0 sc0 ls0 ws1">P<span class="blank _e"></span>ode ser sentido durante a palpação <span class="blank _3d"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 ye ff1 fs0 fc0 sc0 ls0 ws1">Car<span class="blank _0"></span>acterístico do deslocamento de disco <span class="blank _3e"></span><span class="ff5">\u25e6</span></div><div class="t m0 x2 h2 yf ff1 fs0 fc0 sc0 ls0 ws1">\u201cP<span class="blank _e"></span>opping\u201d <span class="blank _3f"></span><span class="ff4">\u2022</span></div><div class="t m0 x3 h2 y10 ff1 fs0 fc0 sc0 ls0 ws1">Ruído alto e sur<span class="blank _0"></span>do <span class="blank _40"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y11 ff1 fs0 fc0 sc0 ls0 ws1">Ocorre quando o comple<span class="blank _0"></span>xo disco-côndilo translada,<span class="blank _0"></span> passando a eminência articular <span class="blank _41"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y12 ff1 fs0 fc0 sc0 ls0 ws1">O dentista pode ouvir<span class="blank _1"></span>, mesmo estando longe do paciente <span class="blank _42"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y13 ff1 fs0 fc0 sc0 ls0 ws1">Car<span class="blank _0"></span>acterístico da luxação articular <span class="blank _43"></span><span class="ff5">\u25e6</span></div><div class="t m0 x2 h2 y14 ff1 fs0 fc0 sc0 ls0 ws1">Crepitação <span class="blank _44"></span><span class="ff4">\u2022</span></div><div class="t m0 x3 h2 y15 ff1 fs0 fc0 sc0 ls0 ws1">Ruído gr<span class="blank _0"></span>ave <span class="blank _45"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y16 ff1 fs0 fc0 sc0 ls0 ws1">É causado por doenças degenera<span class="blank _0"></span>tivas na superfície articular (um furo no disco causa a <span class="blank _46"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y17 ff1 fs0 fc0 sc0 ls0 ws1">fricção de osso com osso,<span class="blank _1"></span> já que o côndilo estará se movimentando em contato dir<span class="blank _0"></span>eto com </div><div class="t m0 x3 h2 y18 ff1 fs0 fc0 sc0 ls0 ws1">a superfície da eminência articular </div><div class="t m0 x0 h2 y19 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 y1a ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 y1b ff2 fs0 fc2 sc0 ls0 ws1">DESL<span class="blank _0"></span>OCAMENT<span class="blank _0"></span>O DO DISCO <span class="blank _0"></span>ARTICULAR<span class="ff1 fc0"> </span></div><div class="t m0 x2 h2 y1c ff1 fs0 fc0 sc0 ls0 ws1">Relação anormal entr<span class="blank _0"></span>e o disco,<span class="blank _0"></span> o côndilo e a eminência articular <span class="blank _47"></span><span class="ff4">\u2022</span></div><div class="t m0 x2 h2 y1d ff1 fs0 fc0 sc0 ls0 ws1">P<span class="blank _e"></span>ode ser anterior<span class="blank _0"></span>,<span class="blank _0"></span> posterior<span class="blank _0"></span>,<span class="blank _0"></span> medial ou lateral <span class="blank _48"></span><span class="ff4">\u2022</span></div><div class="t m0 x2 h2 y1e ff1 fs0 fc0 sc0 ls0 ws1">Causas <span class="blank _49"></span><span class="ff4">\u2022</span></div><div class="t m0 x3 h2 y1f ff1 fs0 fc0 sc0 ls0 ws1">Alongamento dos ligamentos do disco <span class="blank _4a"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y20 ff1 fs0 fc0 sc0 ls0 ws1">Deformação ou a\ufb01namento do bordo posterior do disco <span class="blank _4b"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y21 ff1 fs0 fc0 sc0 ls0 ws1">P<span class="blank _1"></span>ressão excessiva na <span class="blank _0"></span>A<span class="blank _1"></span>TM (apartamento<span class="blank _0"></span>, tr<span class="blank _0"></span>auma) que leva a áreas de r<span class="blank _0"></span>esistência ou adesão <span class="blank _4c"></span><span class="ff5">\u25e6</span></div><div class="t m0 x2 h2 y22 ff1 fs0 fc0 sc0 ls0 ws1">Diagnóstico: Achados clínicos e MRI/ar<span class="blank _0"></span>trogr<span class="blank _0"></span>a\ufb01a <span class="blank _5"></span><span class="ff4">\u2022</span></div><div class="t m0 x2 h2 y23 ff1 fs0 fc0 sc0 ls0 ws1">É dividido em 2 classi\ufb01cações: <span class="blank _4d"></span><span class="ff4">\u2022</span></div><div class="t m0 x3 h2 y24 ff1 fs0 fc0 sc0 ls0 ws1">Com R<span class="blank _0"></span>edução <span class="blank _4e"></span><span class="ff5">\u25e6</span></div><div class="t m0 xd h2 y25 ff1 fs0 fc0 sc0 ls0 ws1">P<span class="blank _1"></span>resença de \u201c<span class="blank _1"></span>click\u201d <span class="blank _4f"></span><span class="ffa">\u2023</span></div><div class="t m0 x3 h2 y26 ff1 fs0 fc0 sc0 ls0 ws1">Sem Redução <span class="blank _50"></span><span class="ff5">\u25e6</span></div><div class="t m0 xd h2 y27 ff1 fs0 fc0 sc0 ls0 ws1">Ausência de ruídos <span class="blank _51"></span><span class="ffa">\u2023</span></div><div class="t m0 xd h2 y6d ff1 fs0 fc0 sc0 ls0 ws1">T<span class="blank _e"></span>ravamento mandibular <span class="blank _16"></span><span class="ffa">\u2023</span></div><div class="t m0 x0 h2 y28 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 y29 ff2 fs0 fc1 sc0 ls0 ws1">Deslocamento de Disco COM R<span class="blank _0"></span>edução <span class="ff1 fc0"> </span></div><div class="t m0 x2 h2 y2a ff1 fs0 fc0 sc0 ls0 ws1">O disco articular é deslocado par<span class="blank _0"></span>a anterior durante o movimento de fechamento e retorna à <span class="blank _52"></span><span class="ff4">\u2022</span></div><div class="t m0 x2 h2 y2b ff1 fs0 fc0 sc0 ls0 ws1">posição normal durante a aber<span class="blank _0"></span>tura mandibular </div><div class="t m0 x2 h2 y2c ff1 fs0 fc0 sc0 ls0 ws1">Causas <span class="blank _49"></span><span class="ff4">\u2022</span></div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf4" class="pf w0 h0" data-page-no="4"><div class="pc pc4 w0 h0"><img fetchpriority="low" loading="lazy" class="bi xf y6e w3 h9" alt="" src="https://files.passeidireto.com/379a7711-6274-4602-a98e-2ca884fa22a2/bg4.png"><div class="t m0 x3 h2 y1 ff1 fs0 fc0 sc0 ls0 ws1">P<span class="blank _e"></span>erda da elasticidade da zona bilaminar <span class="blank _53"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y2 ff1 fs0 fc0 sc0 ls0 ws1">Hipertonicidade do Pterigoide La<span class="blank _0"></span>teral <span class="blank _54"></span><span class="ff5">\u25e6</span></div><div class="t m0 x0 h2 y3 ff1 fs0 fc0 sc0 ls0 ws1">(causa ou efeito) </div><div class="t m0 x3 h2 y4 ff1 fs0 fc0 sc0 ls0 ws1">Enfraquecimento dos ligamentos <span class="blank _55"></span><span class="ff5">\u25e6</span></div><div class="t m0 x0 h2 y5 ff1 fs0 fc0 sc0 ls0 ws1">discais </div><div class="t m0 x2 h2 y6 ff1 fs0 fc0 sc0 ls0 ws1">O \u201c<span class="blank _1"></span>click\u201d representa a r<span class="blank _0"></span>ecaptura do disco <span class="blank _56"></span><span class="ff4">\u2022</span></div><div class="t m0 x0 h2 y7 ff1 fs0 fc0 sc0 ls0 ws1">pelo côndilo </div><div class="t m0 x2 h2 y8 ff1 fs0 fc0 sc0 ls0 ws1">Sinais e sintomas <span class="blank _57"></span><span class="ff4">\u2022</span></div><div class="t m0 x3 h2 y9 ff1 fs0 fc0 sc0 ls0 ws1">P<span class="blank _1"></span>resença de \u201c<span class="blank _1"></span>click\u201d ou \u201cpopping\u201d durante a abertur<span class="blank _0"></span>a <span class="ffb ws2">e</span> fechamento <span class="blank _58"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 ya ff1 fs0 fc0 sc0 ls0 ws1">Desvio da linha média mandibular durante aber<span class="blank _0"></span>tura,<span class="blank _0"></span> para o lado afetado <span class="blank _59"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 yb ff1 fs0 fc0 sc0 ls0 ws1">P<span class="blank _e"></span>ossível presenca de dor (estiramento dos ligamentos) <span class="blank _5a"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 yc ff1 fs0 fc0 sc0 ls0 ws1">Abertur<span class="blank _0"></span>a de boca normal <span class="blank _5b"></span><span class="ff5">\u25e6</span></div><div class="t m0 x2 h2 yd ff1 fs0 fc0 sc0 ls0 ws1">T<span class="blank _e"></span>ra<span class="blank _0"></span>tamento <span class="blank _5c"></span><span class="ff4">\u2022</span></div><div class="t m0 x3 h2 ye ff1 fs0 fc0 sc0 ls0 ws1">Ausência de dor <span class="blank _1d"></span><span class="ff5">\u25e6</span></div><div class="t m0 xd h2 yf ff1 fs0 fc0 sc0 ls0 ws1">Alongamento do ligamento posterior (pseudo disco) <span class="blank _5d"></span><span class="ffa">\u2023</span></div><div class="t m0 xd h2 y10 ff1 fs0 fc0 sc0 ls0 ws1">Monitoramento dos ruídos <span class="blank _5e"></span><span class="ffa">\u2023</span></div><div class="t m0 xd h2 y11 ff1 fs0 fc0 sc0 ls0 ws1">Ou não há indicação de tra<span class="blank _0"></span>tamento <span class="blank _5f"></span><span class="ffa">\u2023</span></div><div class="t m0 x3 h2 y12 ff1 fs0 fc0 sc0 ls0 ws1">P<span class="blank _1"></span>resença de dor <span class="blank _60"></span><span class="ff5">\u25e6</span></div><div class="t m0 xd h2 y13 ff1 fs0 fc0 sc0 ls0 ws1">Restabelecimento do supor<span class="blank _0"></span>te dental posterior (PPR, P<span class="blank _0"></span>T etc) <span class="blank _61"></span><span class="ffa">\u2023</span></div><div class="t m0 xd h2 y14 ff1 fs0 fc0 sc0 ls0 ws1">Placa estabilizadora à noite <span class="blank _62"></span><span class="ffa">\u2023</span></div><div class="t m0 x0 h2 y15 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 ha y16 ffc fs0 fc1 sc0 ls0 ws1">Deslocamento do Disco SEM Redução </div><div class="t m0 x2 h2 y17 ff1 fs0 fc0 sc0 ls0 ws1">O disco articular é deslocado par<span class="blank _0"></span>a anterior durante o movimento de fechamento,<span class="blank _1"></span> seguido de <span class="blank _63"></span><span class="ff4">\u2022</span></div><div class="t m0 x2 h2 y18 ff1 fs0 fc0 sc0 ls0 ws1">falha na recaptur<span class="blank _0"></span>a pelo côndilo durante a abertur<span class="blank _0"></span>a </div><div class="t m0 x2 h2 y19 ff1 fs0 fc0 sc0 ls0 ws1">F<span class="blank _1"></span>ase aguda <span class="blank _64"></span><span class="ff4">\u2022</span></div><div class="t m0 x3 h2 y1a ff1 fs0 fc0 sc0 ls0 ws1">Sinais e sintomas <span class="blank _57"></span><span class="ff5">\u25e6</span></div><div class="t m0 xd h2 y1b ff1 fs0 fc0 sc0 ls0 ws1">Severa r<span class="blank _0"></span>estrição mandibular <span class="blank _65"></span><span class="ffa">\u2023</span></div><div class="t m0 xd h2 y1c ff1 fs0 fc0 sc0 ls0 ws1">De\ufb02exão da linha média para o <span class="blank _66"></span><span class="ffa">\u2023</span></div><div class="t m0 x0 h2 y1d ff1 fs0 fc0 sc0 ls0 ws1">lado afetado (desvio sem retorno à posição </div><div class="t m0 x0 h2 y1e ff1 fs0 fc0 sc0 ls0 ws1">correta) </div><div class="t m0 xd h2 y1f ff1 fs0 fc0 sc0 ls0 ws1">P<span class="blank _1"></span>rotrusão limitada <span class="blank _67"></span><span class="ffa">\u2023</span></div><div class="t m0 xd h2 y20 ff1 fs0 fc0 sc0 ls0 ws1">Restrição da la<span class="blank _0"></span>teralidade para o lado oposto <span class="blank _48"></span><span class="ffa">\u2023</span></div><div class="t m0 xd h2 y21 ff1 fs0 fc0 sc0 ls0 ws1">Later<span class="blank _0"></span>alidade normal no lado afetado <span class="blank _68"></span><span class="ffa">\u2023</span></div><div class="t m0 xd h2 y22 ff1 fs0 fc0 sc0 ls0 ws1">P<span class="blank _1"></span>resença de dor <span class="blank _60"></span><span class="ffa">\u2023</span></div><div class="t m0 xd h2 y23 ff1 fs0 fc0 sc0 ls0 ws1">Ausência de ruídos <span class="blank _51"></span><span class="ffa">\u2023</span></div><div class="t m0 x3 h2 y24 ff1 fs0 fc0 sc0 ls0 ws1">Diagnóstico: Achados clínicos e MRI <span class="blank _69"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y25 ff1 fs0 fc0 sc0 ls0 ws1">T<span class="blank _e"></span>ra<span class="blank _0"></span>tamento <span class="blank _5c"></span><span class="ff5">\u25e6</span></div><div class="t m0 xd h2 y26 ff1 fs0 fc0 sc0 ls0 ws1">Mobilização manual para r<span class="blank _0"></span>edução do disco <span class="blank _6a"></span><span class="ffa">\u2023</span></div><div class="t m0 xd h2 y27 ff1 fs0 fc0 sc0 ls0 ws1">Placa reposicionador<span class="blank _0"></span>a imediata (placa estabilizadora depois de 2 meses) <span class="blank _6b"></span><span class="ffa">\u2023</span></div><div class="t m0 xd h2 y6d ff1 fs0 fc0 sc0 ls0 ws1">Realizar cirur<span class="blank _0"></span>gia em caso de insucesso na mobilização manual <span class="blank _6c"></span><span class="ffa">\u2023</span></div><div class="t m0 x2 h2 y28 ff1 fs0 fc0 sc0 ls0 ws1">F<span class="blank _1"></span>ase crônica <span class="blank _6d"></span><span class="ff4">\u2022</span></div><div class="t m0 x3 h2 y29 ff1 fs0 fc0 sc0 ls0 ws1">Sinais e sintomas <span class="blank _57"></span><span class="ff5">\u25e6</span></div><div class="t m0 xd h2 y2a ff1 fs0 fc0 sc0 ls0 ws1">Disco permanentemente deslocado <span class="blank _6e"></span><span class="ffa">\u2023</span></div><div class="t m0 xd h2 y2b ff1 fs0 fc0 sc0 ls0 ws1">Abertur<span class="blank _0"></span>a mandibular normal <span class="blank _65"></span><span class="ffa">\u2023</span></div><div class="t m0 xd h2 y2c ff1 fs0 fc0 sc0 ls0 ws1">Ausência de dor<span class="blank _1"></span>, ou dor não sever<span class="blank _0"></span>a <span class="blank _5f"></span><span class="ffa">\u2023</span></div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf5" class="pf w0 h0" data-page-no="5"><div class="pc pc5 w0 h0"><div class="t m0 xd h2 y1 ff1 fs0 fc0 sc0 ls0 ws1">P<span class="blank _1"></span>resença de cr<span class="blank _0"></span>epitação <span class="blank _6f"></span><span class="ffa">\u2023</span></div><div class="t m0 x3 h2 y2 ff1 fs0 fc0 sc0 ls0 ws1">Contr<span class="blank _0"></span>ole <span class="blank _70"></span><span class="ff5">\u25e6</span></div><div class="t m0 xd h2 y3 ff1 fs0 fc0 sc0 ls0 ws1">Mobilização manual e placa reposicionador<span class="blank _0"></span>a <span class="blank _23"></span><span class="ffa">\u2023</span></div><div class="t m0 xd h2 y4 ff1 fs0 fc0 sc0 ls0 ws1">Placa estabilizadora <span class="blank _71"></span><span class="ffa">\u2023</span></div><div class="t m0 xd h2 y5 ff1 fs0 fc0 sc0 ls0 ws1">Aplicação de calor úmido,<span class="blank _1"></span> dieta macia, r<span class="blank _0"></span>elaxantes musculares em caso de dor <span class="blank _72"></span><span class="ffa">\u2023</span></div><div class="t m0 xd h2 y6 ff1 fs0 fc0 sc0 ls0 ws1">Fisioter<span class="blank _0"></span>apia <span class="blank _73"></span><span class="ffa">\u2023</span></div><div class="t m0 xd h2 y7 ff1 fs0 fc0 sc0 ls0 ws1">Ou,<span class="blank _0"></span> em caso de ausência de dor<span class="blank _1"></span>, o tr<span class="blank _0"></span>atamento pode não ser indicado <span class="blank _74"></span><span class="ffa">\u2023</span></div><div class="t m0 x0 h2 y8 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 y9 ff1 fs0 fc0 sc0 ls0 ws1"> </div><div class="t m0 x0 h2 ya ff2 fs0 fc2 sc0 ls0 ws1">DESL<span class="blank _0"></span>OCAMENT<span class="blank _0"></span>O D<span class="blank _0"></span>A <span class="blank _0"></span>ARTICULAÇ<span class="blank _0"></span>ÃO - L<span class="blank _0"></span>uxação <span class="ff1 fc0"> </span></div><div class="t m0 x2 h2 yb ff1 fs0 fc0 sc0 ls0 ws1">Os côndilos são deslocados para a r<span class="blank _0"></span>egião anterior da eminência articular é um espasmo <span class="blank _75"></span><span class="ff4">\u2022</span></div><div class="t m0 x2 h2 yc ff1 fs0 fc0 sc0 ls0 ws1">muscular posiciona o côndilo superiormente,<span class="blank _0"></span> impedindo o seu retorno à fossa glenoide </div><div class="t m0 x2 h2 yd ff1 fs0 fc0 sc0 ls0 ws1">P<span class="blank _e"></span>ode ocorrer espontaneamente ou pode evoluir de pr<span class="blank _0"></span>oblemas já presentes na lâmina <span class="blank _76"></span><span class="ff4">\u2022</span></div><div class="t m0 x2 h2 ye ff1 fs0 fc0 sc0 ls0 ws1">retr<span class="blank _0"></span>odiscal superior </div><div class="t m0 x2 h2 yf ff1 fs0 fc0 sc0 ls0 ws1">Sinais e sintomas <span class="blank _57"></span><span class="ff4">\u2022</span></div><div class="t m0 x3 h2 y10 ff1 fs0 fc0 sc0 ls0 ws1">Mandíbula travada com a boca aber<span class="blank _0"></span>ta <span class="blank _77"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y11 ff1 fs0 fc0 sc0 ls0 ws1">P<span class="blank _1"></span>resença de dor no fechamento bucal <span class="blank _78"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y12 ff1 fs0 fc0 sc0 ls0 ws1">Maloclusão severa <span class="blank _13"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y13 ff1 fs0 fc0 sc0 ls0 ws1">Depressão na ár<span class="blank _0"></span>ea pr<span class="blank _0"></span>é-auricular <span class="blank _10"></span><span class="ff5">\u25e6</span></div><div class="t m0 x2 h2 y14 ff1 fs0 fc0 sc0 ls0 ws1">Contr<span class="blank _0"></span>ole <span class="blank _70"></span><span class="ff4">\u2022</span></div><div class="t m0 x3 h2 y15 ff1 fs0 fc0 sc0 ls0 ws1">Exer<span class="blank _0"></span>cício de abertura bucal contr<span class="blank _0"></span>a uma resistência <span class="blank _2"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y16 ff1 fs0 fc0 sc0 ls0 ws1">Mobilização manual da mandíbula (o dentista deve usar luvas,<span class="blank _0"></span> pois o retorno da mandíbula <span class="blank _79"></span><span class="ff5">\u25e6</span></div><div class="t m0 x3 h2 y17 ff1 fs0 fc0 sc0 ls0 ws1">é abrupto,<span class="blank _1"></span> podendo causar mordeduras) </div><div class="t m0 x3 h2 y18 ff1 fs0 fc0 sc0 ls0 ws1">Relaxantes muscular<span class="blank _0"></span>es e/ou analgésicos <span class="blank _7a"></span><span class="ff5">\u25e6</span></div><div class="t m0 x0 h2 y19 ff1 fs0 fc0 sc0 ls0 ws1"> </div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div>
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