The temporomandibular joint (TMJ) is certainly one of the most complex in the body. From its operation, classification to the origin of the existing dysfunctions that involve it. The etiology of temporomandibular disorders (TMD) is multifactorial and complex, recent studies point to a great relationship between psychological problems and TMD, not as a direct factor, but corroborating with others or working as triggers for signs and symptoms. In the clinical routine, patients with TMJ-related complaints are accompanied by some level of depression and / or anxiety, making the treatment even more comprehensive, requiring the dentist to treat the patient as a whole and not just the TMJ or mouth, referring for other professionals, being a multidisciplinary treatment. In the present work, keywords such as ‘’ temporomandibular disorder ’’, ‘‘ depression ’’ and ‘’ ‘anxiety’ ’were used in the PubMed, BVS and Scielo databases. TMD is still very complex in the literature, mainly to determine the factors that cause it exactly in each patient, so it is important to further studies in this area, seeking a greater elucidation of the topic.

Bruxism is a parafunctional habit of multifactorial origin, which causes functional disorders with severe clinical implications. This function may be related to emotional factors, anxiety, and to behavioral characteristics of the individual. The objective of this work was to evaluate the prevalence of bruxism during waking and sleep bruxism describing aspects related to anxiety. Determining the etiological factor is important for diagnosis and treatment, to improve the quality of life of patients with the habit. The present study reviewed the literature on the relationship between bruxism and anxiety, addressing the main ways of treating this dysfunction. The keywords “bruxism”, “anxiety”, “etiology” and “sleep bruxism” were used in the PubMed and VHL databases. The references that dealt with the subjects related to the proposed theme were chosen, published during the last 20 years. He observes that the approach and treatment of the patient with bruxism and anxiety must be multidisciplinary, and that the direct relationship between the two diseases is not easy to be determined, as there is no scientific evidence of sleep bruxism and bruxism in wake. Thus, the evidence elucidates that there is a need for well-designed studies. In addition, the forms of treatment available are numerous, and that to be effective, therapies must be multidisciplinary, depending on the determination of the etiological factors of the two pathologies, and on the assessment of the risks and benefits of each therapy for the patient to be treated.

Institutionalized elderly people usually have a different oral condition than the elderly population in general due to the association of several systemic diseases, in addition to poor oral health care. Chronic age-related illnesses, such as dyslipidemia, hypertension, diabetes and depression, usually require the use of multiple drugs, a condition known as polypharmacy. This refers to the use of several medications daily. The present research aimed to verify the oral manifestations in gingiva, gingival ridge, as well as, in the other areas covered by epithelium resulting from polypharmacy in the elderly of a public shelter in Teresina - PI. In this study carried out between October / 2017 to April / 2018, 62 elderly people who met the stipulated inclusion criteria were evaluated, and the participants were institutionalized in a public shelter in Teresina - PI, who had the physical condition to open the oral cavity for the intraoral physical examination. , regardless of sex, education level, social class, who had chronic diseases and who used five or more drugs from different groups on a daily basis, thus characterizing polypharmacy. At the end of the analysis, there were nine elderly people who fit the research standards; they were subclassified according to the degree of the referred pathology and were made aware (patient and caregiver) about the magnitude of the problem and how to ponder and / or remove it. Polypharmacy was present in the entire sample studied and the main manifestations found were: gingival hyperplasia, gingivitis, ulcerations / erythematous areas, lingual coating, dry mouth and candidiasis.

A mandíbula é o único osso móvel da face e possui função na mastigação, deglutição, fonação e estética facial. É fraturada com frequência, possuindo origem variada, tendo prevalência de idade até os 40 anos, em casos de queda da própria altura é mais frequente em crianças e idosos. Paciente do sexo masculino, 64 anos, vítima de acidente motociclístico, compareceu ao serviço de Cirurgia e Traumatologia Bucomaxilofacial do Hospital de Urgência de Teresina. Ao exame clínico apresentava edema, lacerações e escoriações na face no lado direito, apresentou degrau ósseo à palpação de mandíbula em região de ângulo direito e sínfise. Ao exame de imagem, constatou-se, na tomografia computadorizada, a presença de uma descontinuidade do arco mandibular com múltiplos traços de fratura, em região de ângulo direito, corpo direito e sínfise da mandíbula esquerda. Fechando o diagnóstico em Fratura complexa de mandíbula, encaminhando assim, a intervenção cirúrgica para redução e fixação da fratura. Utilizou- se quatro placas do sistema 2.0. Realizou-se a infiltração local com xilocaína com vasoconstritor 2%, incisão para o acesso de Risdon (submandibular), exposição da fratura, reanatomização dos fragmentos ósseos e a osteossíntese com duas placas 2.0 e 15 parafusos em área de compressão e tensão, o mesmo foi feito no acesso intraoral na região de sínfise. Por fim, sutura por planos. O paciente teve alta hospitalar com um dia e seguiu com acompanhamento ambulatorial. A partir do caso apresentado, em casos de fraturas de mandíbula o acesso extra oral de risdon e o intraoral se mostram eficazes e seguros.

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