Esther Mandelbaum Gonçalves Bianchini

Medidas antropométricas de comprimento de lábio superior e filtro

BACKGROUND: indirect anthropometrical measurements of the height of the upper lip and length of the philtrum. AIM: to describe the measurements of the height of the upper lip and length of the philtrum, extracted from video x-rays, in children with mixed dentition, relating these measurements to facial typology - medium and long -, to occlusion - Angles class I and II - and to the rest position of the lips - with and without lip seal. METHOD: verification of 123 x-rays, in lateral norm, of children with ages between 7:7 and 11:10 years, 56 male and 67 female, extracted from archives of orthodontical documentation prior to treatment. RESULTS: the T-Student test, with a significance level of 5%, was used for the statistical analyses and the obtained results were: for the height of the upper lip no statistical difference was found considering the variables of face typology, occlusion and gender; there was no statistical difference for the measurements of the philtrum considering the variables of face typology and occlusion, but a statistically significant difference was found for the variable gender; a statistically significant difference was found for the height of the upper lip and length of the philtrum considering the variable rest position of the lips - with and without lip seal - being this a determinant factor for the measurements. This finding suggests that a direction of structural modifications may exist. CONCLUSION: the mean value for the height of the upper lip was established at 21mm; the mean value for the length of the philtrum was established at 12mm. It is important to consider the rest posture of the lips, during assessment and therapy, when taking the measurements of the height of the upper lip and length of the philtrum.

Verificação e análise morfofuncional das características da mastigação em usuários de prótese dentária removível

PURPOSE: to check mastication characteristics in individuals using removable dental prosthesis, analyzing probable interference factors associated to functional mastication. METHODS: fifty-three individuals of both genders, between 42 and 67 year old, were divided in two groups: thirty-two individuals, users of total stable prosthesis dentures and/or partially stable removable prosthesis (G1); and twenty-one individuals with natural dentition (G2). the following exclusion criteria were used: neurological or cognitive deficiency, dental facial deformities, temporomandibular disorders and any mouth injuries which could interfere in mastication. Evaluation was done with salt bread, using habitual mastication. The analyses focused on: oral structures and muscle characteristics; type of cutting, maintenance of labial sealing; length of mastication time, number of masticatory cycles, and type of mastication: uni or bilateral, considering unilateral predominance in more than 66% of the cycles on just one particular side. RESULTS: alterations were noted as for the characteristics of the masseter muscle and type of food cutting for G1, with significant statistical differences when compared to G2. All other orofacial structures: lips, tongue, cheeks, mentual, and position of lips during mastication proved to be normal for both groups. There was no significant difference between the groups regarding jaw movements; type, time, and number of masticatory cycles and deglutition characterization. CONCLUSION: mastication in removable prosthesis users is characterized by alterations in the form of cutting food, undefined type of mastication, and satisfactory lips posture. The average time and the number of masticatory cycles are similar to those obtained for individuals with natural dentitions.

Voz e disfunção temporomandibular em professores

OBJETIVO: Verificar a presenca e possivel correlacao entre alteracao vocal e disfuncao temporomandibular (DTM), em professores, a partir de dados de avaliacao auto-referida, fonoaudiologica, otorrinolaringologica e odontologica. JUSTIFICATIVA: Esta pesquisa foi planejada partindo do pressuposto de que pode haver correlacao entre a presenca de alteracao de voz e DTM. Na presenca dessa correlacao, atividades que envolvam a promocao de saude e prevencao de alteracoes, tanto relacionadas a DTM quanto a voz, auxiliarao os professores a melhorar suas condicoes de saude e, consequentemente, de trabalho. METODO: Participaram deste estudo, de natureza transversal observacional, 29 professores de uma escola da rede publica do ensino fundamental e medio, do municipio de Sorocaba/SP. O estudo foi desenvolvido por uma equipe multidisciplinar, composta por um medico otorrinolaringologista, duas fonoaudiologas e um odontologo (especialista em cirurgia bucomaxilofacial). Todos os professores responderam questionario auto-referido (adaptado de BIANCHINI, 2000 e FERREIRA et al., 2007), que contou com questoes relativas a identificacao, aspectos concernentes a alteracoes vocais e queixas referentes a disfuncao da articulacao temporomandibular. Em seguida, passaram por quatro avaliacoes: qualidade de voz (avaliacao perceptivo-auditiva); exames de laringe (videonasolaringoscopia), motricidade orofacial e odontologico. Foi considerado como alteracao de voz e de DTM aquele que apresentou tres ou mais sinais e/ou sintomas no questionario, avaliacoes de motricidade orofacial e odontologica. Na analise estatistica dos dados, foram empregados o Teste Exato de Fisher e o de Concordância Kappa. RESULTADOS: 82,8% dos participantes fizeram auto-referencia a alteracao vocal e 62,1% de sintomas de DTM; 51,7%, alteracao de voz na otorrinolaringologica e 65,5%, alteracao de DTM na avaliacao odontologica. Na comparacao das propostas de avaliacao de alteracao de voz e DTM foi registrada tendencia significativa para a aplicacao do questionario. Por outro lado, tanto na analise da relacao, quanto na de concordância foi a avaliacao fonoaudiologica (perceptivo-auditiva da voz e de motricidade orofacial para DTM) que se mostrou significativa

Características do tipo de alimentação e da fala de crianças com e sem apinhamento dentário

ABSTRACTPurpose: to characterize the kind of food consistence and speech production in children with normal occlusion and malocclusion related to tooth crowding, as well as to verify possible correlations and interferences. Methods: sixty children from 7 to 12 years old, both genders, divided in two groups: (G1) formed by thirty children with tooth crowding and (G2), the control group, formed by thirty children without tooth crowding. Exclusion criteria: neurological or cognitive problems, oral habits, mouth breathing, dento-facial deformities, orthodontic or speech and language treatment. The procedures were: oral myofunctional and speech evaluation, dentistry evaluation and the appliance of two questionnaires to the children’s parents about the child’s history and nutrition habits regarding the food consistence. Results: children without tooth crowding usually eat mainly solid food, while those with a crowding arch usually eat softened food, mostly in fl uenced by the habit of drinking while the food is still in the mouth.

Caracterização das funções estomatognáticas e disfunções temporomandibulares pré e pós cirurgia ortognática e reabilitação fonoaudiológica da deformidade dentofacial classe II esquelética

PURPOSE: to investigate and to describe the functional characterization and temporomandibular disorders (TMD) before and after orthognathic surgery and myofunctional treatment of Class II Dentofacial deformity patients. METHOD: a longitudinal study including 22 subjects with Class II dentofacial deformity, defined after analysis of inclusion and exclusion criteria, was conducted. The investigation was divided in 2 steps: myofunctional evaluation prior to the surgery and a re-evaluation 4 months after the orthognathic surgery and myofunctional treatment. Statistical tests were used to compare the data. RESULTS: initial complaints included functional difficulties. The functional disorders were described. TMD was observed in the majority of the sample. After treatment the complaints decreased; the majority of the patients showed remission of the TMD and functional improvement. CONCLUSION: there are specific myofunctional modifications related to the stomatognathic functions and to TMD in Class II Dentofacial deformity patients. Both the surgery and the speech therapy produced myofunctional modifications, with reduction of initial complaints, as well as a decrease of TMD and correction of functional patterns. The swallowing function was the most benefited by the treatments.

Caracterização da função mastigatória em crianças com dentição decídua e dentição mista

OBJETIVO: caracterizar a mastigacao de criancas com denticao decidua e com denticao mista, buscando verificar se ha variacoes inerentes ao processo de desenvolvimento desta funcao. METODOS: participaram 78 criancas, 4 a 11 anos, ambos os generos, divididas em dois grupos: GI - denticao decidua completa e GII - denticao mista. Foi realizada inspecao visual das estruturas do sistema estomatognatico seguida da avaliacao da mastigacao, utilizando-se pao frances. A coleta dos dados foi realizada por meio da observacao visual direta e registro em video, visando confirmacao dos dados observados, analisando-se os seguintes dados durante a mastigacao: tipo de mordida, postura de labios, amassamento com a lingua, quantidade ingerida, padrao mastigatorio, ciclos mastigatorios, movimentos mandibulares, uso dos dedos para juntar o alimento e verificacao de movimentacao exagerada da musculatura perioral. RESULTADOS: pode-se considerar que criancas de G1 e G2 apresentam as seguintes caracteristicas: mordida frontal, porcao media de alimento, presenca de vedamento labial, media de 27 ciclos mastigatorios por porcao, movimentos mandibulares rotatorios, ausencia de amassamento do alimento com a lingua, ausencia da utilizacao dos dedos para juntar o alimento e ausencia de uso exagerado da musculatura perioral. Nao foram encontradas diferencas estatisticamente significantes entre as caracteristicas mastigatorias dos dois grupos, sendo que apenas a presenca de amassamento do alimento com a lingua e predominante na denticao decidua. CONCLUSAO: parece nao existir diferenciacao das caracteristicas quanto ao padrao mastigatorio em relacao as fases de denticao estudadas, sendo apenas o amassamento do alimento mais frequente na decidua.

Anquilose temporomandibular bilateral: aspectos fonoaudiológicos e procedimentos clinidos

PURPOSE: to submit an oral miofunctional therapeutic proposal, the procedures used in cases of bilateral ankylosis of the temporomandibular and the results, joint standing out the importance of interdisciplinary work and the oral miofunctional therapy contribution to rehabilitation of the stomatognatic system in these cases. METHODS: this case report is about an adult, male, referred to evaluation and specific procedures three months after the joint surgery. Core complaint was great restriction of mouth opening range. The oral miofuncional exam assessment has shown: mouth opening of 25 mm, lack of laterality and protrusion movements, previous open bite of 8 mm, difficulty in chewing, swallowing, speech articulation and pain in temporal muscles. The therapeutical objectives were: stimulate and allow the execution of mandible movements, preventing restrictive cicatricial tissue and functional rehabilitation. Procedures related to increasing the amplitude through looseness, stretching, massages, and specific maneuvers as distraction and lever had been essential to stabilize the opening of the mouth, to liberate the mandible movements partially and to co-ordinate them as long as it improves the functionality of the stomatognatic system. RESULTS: after 24 sessions were: gain of 16 mm in the opening, passing to 41 mm with stability according to annual control; reduction of the previous bite open for 4 mm; improvement in the hygienic cleaning, in the speech articulation, in the alimentary conditions with acquisition of chewing strength and reduction of the compensatory mechanisms; elimination of pain in the region of the temporal muscles in addition to improvement in the facial esthetics. CONCLUSION: the oral miofunctional therapeutic reveals itself efficient in adult with bilateral ankylosis of the temporomandibular joint, after surgical procedure, with stability of results maintained according to annual control.

Associação entre distúrbio de voz e sintomas de disfunção temporomandibular autorreferidos por professores

Purpose : To verify the relationship between voice disorder and temporomandibular dysfunction (TMD) in elementary and middle school teachers. Methods : The participants of this study were 138 teachers - 96 women and 42 men, with a mean age of 38 years. The teachers responded to a questionnaire with five questions on voice disorder and temporomandibular dysfunction symptoms. The data were analyzed using an association test (Chi-square) to verify the association between voice disorder and temporomandibular dysfunction symptoms, as well as the relationship of the symptoms with sex and age. Results : The temporomandibular dysfunction symptoms reported by the teachers, from the most to least frequently mentioned, were as follows: headache or facial pain, pain at the end of the day, and pain when speaking excessively. The results showed a statistically significant difference for the symptom pain when speaking excessively, pain at the end of the day, and temporomandibular joint snap in teachers without voice disorder. A statistically significant difference was observed for the female sex, regarding temporomandibular dysfunction. Temporomandibular dysfunction was more frequently reported than voice disorder, with higher incidence in female than in male teachers. Conclusion : The findings showed a statistical association between voice disorder and temporomandibular dysfunction in teachers. Further studies with integrated clinical assessment on the relationship between voice symptoms and TMD in different age groups are warranted.

Scientific production of Brazilian speech language pathologists insleep medicine

Introduction: Previous diagnosis and intervention in patients with sleep-disordered breathing involves several health professionals. Speech-Language and Hearing Sciences (SLHS) performance has been solidified through scientific production. Objective: To describe the inclusion of Brazilian Speech-Language Pathologists (SLP) in the field of sleep disorders, through the description of studies, scientific publications and participation in scientific events. Data Synthesis: A search and an analysis of the Brazilian SLP publications in the field of sleep disorders were carried out, including articles, monographs, dissertations, thesis and abstracts published in annals of events. The databases Lilacs, SciELO, Pubmed, Google Scholar tool and Lattes platform were accessed, with final search in January 2018. The analysis consisted of a description of the year of publication, type of publication, area of the SLHS, place of publication and/or event. 40 articles were found in national and international journals, from 1999 to 2017. In relation to publications in books, one book about the subject was published in 2009 and eight chapters of books were published. In the monograph format, 21 studies were carried out, there are 13 dissertations and eight thesis. A total of 151 abstracts were published in annals of scientific events, from 2001 to 2017 and 63 lectures were conducted by SLP. Conclusion: The inclusion of Brazilian SLP in the area of sleep disorders has been supported by scientific publications in the format of articles in national and international journals, monographs, thesis, dissertations, books and publications in event annals.

Terapêutica interdisciplinar para fratura cominutiva de côndilo por projétil de arma de fogo: enfoque miofuncional

BACKGROUND: firearm wounds are relatively frequent and show high incidence at the head and face area. Temporomandibular joint may be involved, and also some important anatomic structures as the facial nerve directing the need for an interdisciplinary team in order to promote an efficient treatment. PROCEDURES: a case report related to a comminuted condyle fracture caused by firearms with a nonsurgical treatment associated to myofunctional therapy. The patient was referred to Speech and Language Pathologist after the conduct of oral and maxillofacial surgery team, without removing the bullet, lodged superficially near the origin of the sternocleidomastoid muscle on the right side; with comminuted condyle fracture and facial nerve damage. Myofunctional evaluation found an important reduction in the mandibular movement amplitude with severe deviations as for the affected side, no contralateral laterality, muscle pain; paralysis and paresthesia on the right side of the face. Myofunctional therapy followed a specific protocol for facial trauma including: drainage of edemas, specific ipsilateral manipulations on jaw muscles; correction and enlargement of the mandibular movements, specific procedures related to facial paralysis and directed functional reorganization. RESULTS: after eight therapy sessions we obtained: mandibular movements with adequate amplitude and symmetry, chewing reorganization, adequacy of swallowing and speech, remission of painful symptoms and remission of paralysis in the medium third of the face. CONCLUSION: the conservative treatment for comminuted condyle fracture through myofunctional therapy resulted in functional rehabilitation of the jaw and face, directing the movements and stimulating the adequacy of the sthomatognatic functions.