Ana María Biondi

Relación de disfunciones y hábitos parafuncionales orales con trastornos temporomandibulares en niños y adolescentes

UNLABELLED Oral parafunctional habits and orofacial myofunctional dysfunctions are commonly observed in children and considered as contributory factors for temporomandibular disorders (TMD). The aim of this work was to describe the frequency of oral parafunctional habits and orofacial myofunctional dysfunctions and to evaluate the association between them and signs and symptoms of TMD in patients attending to the TMD section of the Pediatric Dentistry Department of the University of Buenos Aires. METHODS Data obtained from dental records performed during 2003-2007 were entered into a database registering age, gender, reason for consultation, psychological stress, signs, symptoms, diagnosis, dysfunctions and parafunctions, for statistical analysis. RESULTS The sample was constituted by 133 patients (average age: 12 +/- 3 years old). Ninety six percent of patients showed dysfunctions and/or parafunctions. Regarding dysfunctions, they were present in 78% of the sample; 48% had dysfunctional swallowing; 45% oral and mixed breathing, and 29% chewing food on one preferred side. With regard to parafunctions, bruxism was present in 74% of cases, gum chewing habit in 55%, nail biting in 48%, biting in 28%, jaw play in 22%, and sucking in 14%. TMD symptoms were associated with total dysfunctions and parafunctions (p <0.05). Using multivariate analysis, results showed a significant correlation between masticatory dysfunction and clicking joint noise (p= 0.023) and bruxism as reason for consultation (p= 0.018). CONCLUSIONS Dysfunctions and parafunctions showed in this study a high prevalence and were significantly associated with TMD symptoms.

Determination of Range of Mandibular Movements in Children without Temporomandibular Disorders

Abstract Mandibular movement values are an important parameter within the clinical evaluation of the temporomandibular joint. Limited or increased movement is a sign of dysfunction. Normal values used as reference correspond to adult populations, and information on child populations is scant. The aim of this study was to establish reference measurements of children with primary (Group A) and mixed dentition (Group B) without signs of temporomandibular disorders. The study population comprised 212 boys and girls, aged 3 to 11 years, attending a state school in the San Martín district in the province of Buenos Aires, who presented no joint sounds, clicking or pain. A calibrated operator determined maximal opening, protrusion, and lateral movements. Group A (n=105): mean age 4.61±0.9; maximal opening 38.59 mm ±4.03; protrusion 3.71 mm±1.79; right lateral movement 5.43 mm±1.83 and left lateral movement 5.52 mm ± 1.73. Group B (n= 107): mean age 6.9±1.65; maximal opening 41.97 mm ± 5.27; protrusion 3.96 mm±1.92; right lateral movement 6.05 mm±1.99 and left lateral movement 6.13 mm±2.21. Opening and lateral movements were found to increase with age. Comparison between groups using Welch t Test showed significant differences in maximal opening (p<0.0001), right (p= 0.0191) and left (p=0.0262) lateral movement. Conclusions: Mandibular movements are associated with growth. Mandibular movements of pediatric patients must be assessed in relation to age and type of dentition.

Frequency of oral habits, dysfunctions, and personality traits in bruxing and nonbruxing children: a comparative study.

Abstract The aim of the current study was to compare personality traits, presence of oral myofunctional dysfunctions, and other parafunctional habits in bruxing and nonbruxing children. Fifty-four patients aged 10 to 15 years were seen at the Comprehensive Pediatric Dental Clinic and examined by dentists using the RDC/TMD; speech therapists and psychologists were included in the study. Patients were divided into two groups: bruxing (A) and nonbruxing (B). Mean age was 13.1 years, S.D. 1.6. No significant differences in age or gender were found between groups. Group A comprised 44.44% of the population and showed a high frequency of middle conscientiousness scores and low frequency of low neuroticism scores. Presence of TMD, unilateral chewing, and high tongue tip position at rest were all significantly higher. Frequency of oral habits was higher in bruxers, who showed significantly increased gum chewing, and lip, cheek, and object biting compared to nonbruxing controls. Bruxism is considered a risk factor for temporomandibular dysfunction (TMD).

Comparación de la prevalencia de hipomineralización molar incisiva en niños con diferente cobertura asistencial en las ciudades de Buenos Aires (Argentina) y Montevideo (Uruguay)

The aim of this study was to compare the prevalence of molar incisor hypomineralization (MIH) among children with different health care coverage in Buenos Aires and Montevideo. An observational, cross-sectional and descriptive study was designed, considering children born from 1993-2003 who were seen in the Chairs of Comprehensive Childrens Dentistry (Universidad de Buenos Aires) and of Pediatric Dentistry (Universidad de la República) and at five private dental offices between April and December 2010. Two groups were defined: A (Buenos Aires; n=1,090) and B (Montevideo; n=626). The clinical diagnosis was carried out with calibrated examiners (Kappa: 0.94) using the Mathu-Muju and Wright criteria. The prevalence of MIH was found to be 16.1% in A and 12.3% in B (p=0.03), with statistically significant differences between the public and private care sectors in both groups (A p=0.0008; B p=0.0004) and a positive correlation between MIH and year of birth (A p=0.001; B p=0.005). The results show that MIH is an emerging pathology and that MIH prevalence is related to year of birth and access to health care.