Marilena Manno Vieira

Respiração oral: relação entre o tipo facial e a oclusão dentária em adolescentes

ABSTRACT Purpose: To investigate the existence of a relationship between facial type and dental occlusion in oral breathing adolescents. Methods: Forty adolescents, 25 (62.50%) boys and 15 (37. 50%) girls, with ages between 13 and 16 years and otorhinolaryngologicaldiagnosis of oral breathing, were assessed. All subjects were submitted to an anamnesis and a Clinical Exam carried out by a speechpathologist, which consisted of facial and dental occlusion evaluation. Results: The most common results observed were:hyperleptoprosopic facial type in 25 (62.50%) adolescents, the Class II first division malocclusion in 22 (70.97%), normal anterioroverbite in 26 (65.00%), normal posterior overbite in 32 (80.00%) and normal anterior and posterior overjet in 28 (70.00%)adolescents. In the hyperleptoprosopic facial type, top anterior overbite was observed in 06 (42.86%) and the top posterior overbitein 05 (62.50%) adolescents. Abnormal anterior overjet was observed in 04 (33.33%), the top posterior overjet and cross-bite in 05(41.67%) patients.

Maximum Bite Force Analysis in Different Age Groups

Introduction Maximum bite force (MBF) is the maximum force performed by the subject on the fragmentation of food, directly related with the mastication and determined by many factors. Objective Analyze the MBF of subjects according to age groups. Methods One hundred individuals from the city of São Paulo were equally divided according to age groups and gender. Each individual submitted to a myotherapy evaluation composed of anthropometric measurements of height and weight to obtain body mass index (BMI), using a tape and a digital scale (Magna, G-life, São Paulo), and a dental condition and maximum bite force evaluation, using a digital dynamometer model DDK/M (Kratos, São Paulo, Brazil), on Newton scale. The dental and bite force evaluations were monitored by a professional from the area. Analysis of variance was used with MBF as a dependent variable, age group and gender as random factors, and BMI as a control variable. Results Till the end of adolescence, it was possible to observe a decrease in MBF in both sexes, with the male force greater than the female force. In young adults, the female force became greater the males, then decreased in adulthood. There was no correlation between MBF and BMI. Conclusion There are MBF variations that characterizes the human development stages, according to age groups.

A study on the relationship between mouth breathing and facial morphological pattern

UNLABELLED Breathing is responsible for facial and cranial morphology development. AIM investigate in order to see if there is any relationship between oral breathing and facial type. MATERIAL AND METHODS 119 male and female teenagers, with ages ranging between 15 and 18 years. The sample was separated in two groups: A-50 teenage oral breathers, 28 males and 22 females; and group B- 69 teenage nasal breathers, 37 males and 32 females. The sample was collected at the Centro de Atendimento e Apoio ao Adolescente do Departamento de Pediatria da UNIFESP/ EPM. We evaluated breathing and facial measures. RESULTS by means of anthropometric indexes we classified facial types and associated them with the persons breathing type, Hypereuriprosopic (Total=0; oral breathers 0%; nasal breathers 0%; Euriprosopic (Total=14; oral breathers 2.52%, nasal breathers 9.24%;Mesoprosope (Total=20; oral breathers 19.32%; nasal breathers 21.01%, Leptoprosopic (Total=37; oral breathers 14.29%; nasal breathers 16.81%; Hyperleptoprosopic (Total =48; oral breathers 5.89% nasal breathers 10.92%). The mesoprosopic facial type was found in 48 teenagers (40.33%) of whom 25 (21.01%) were oral breathers and 23 (19.32%) were nasal breathers. CONCLUSION it was not possible to prove the existence of an association between oral breathing and facial type.

Avaliação comportamental do processamento auditivo em indivíduos pós - traumatismo cranioencefálico: estudo piloto

PURPOSE: to characterize the performance of individuals after traumatic brain injury in behavioral tests to evaluate auditory processing. METHOD: the participants of this research were 10 individuals with normal hearing with traumatic brain injury. They were submitted to: pure tone audiometry, speech audiometry, acoustic immittance measures (tympanometry and acoustic reflex) and behavioral evaluation of auditory processing (Sound Location Test, Verbal Sequential Memory, Non Verbal Sequential Memory, Duration Pattern Sequence Test, Dichotic Consonant-vowel, Staggered Spondaic Word (Portuguese version), Identification of synthetic sentences with competitive message, Random Gap Detection Test, Percentage Index of Speech Recognition with recording, speech test). RESULTS: the test of Duration Pattern indicated the test with the largest number of alteration (60%). The test with the most satisfactory average was the Percentage Index of Speech Recognition with recording (93%) and the less satisfactory average test was related to dichotic consonant-vowel (40,56%). The reversals (70%) represented the tendency of more frequent errors in the SSW. The damage of decoding was the most prevalent (100%), followed by the organization (90%), supra-segmental (60%) and encoding-gradual loss of memory (20%). There was no damage of encoding-integration. CONCLUSIONS: the patients after traumatic brain injury present auditory processing disorders of varying degrees, involving the processes of decoding and organization.

Análise da força de mordida nos diferentes tipos de maloclusões dentárias, segundo Angle

Purpose: to analyze the maximum bite force in individuals with normal occlusion and types of Angle’s malocclusion; to observe the frequency of occurrence of each type of occlusion; to analyze whether there is any difference between measurements of force and relate bite force to body mass index (BMI). Methods: the sample was composed of 100 students of the Speech and Language Pathology School at UNIFESP, with ages between 17 and 25 years. Individuals with ATM disfunctions, mental or genetic disorders and those who had already undergone miotherapy were excluded. Each individual went through an evaluation, which consisted of: 1) gathering personal information, personal diet, chewing preference, weight and height. 2) evaluation of dental occlusion as normal occlusion or malocclusion Class I, Class II 1 st division, Class II 2 nd division or Class III. 3) evaluation of bite force, performed by using a digital dynamometer. Different techniques were used for statistical analysis. Results: individuals with normal occlusion were those who had the greatest bite force, followed by Classes I, II 1 st and 2 nd divisions and Class III, respectively; there was higher occurrence of malocclusion Class I, followed by normal occlusion, Class II 1 st and 2 nd divisions and Class III; There was an increase of the average force between the first and third measurements for both sides; there was no correlation between bite force and BMI. Conclusion: the type of occlusion influenced bite force, the greatest force being obtained on the third measurement; there was no relation between BMI and bite force.

Fatores predisponentes de desordem temporomandibular em crianças com 6 a 11 anos de idade ao início do tratamento ortodôntico

INTRODUCTION: The etiology of temporomandibular disorders (TMDs) is currently considered multifactorial, involving psychological factors, oral parafunctions, morphological and functional malocclusion. OBJECTIVES: In keeping with this reasoning, we evaluated children who seek preventive orthodontic treatment, to better understand their grievances and to assess the prevalence of TMD signs and symptoms in these patients. METHODS: Two examiners evaluated 65 children aged 6 to 11 years. RESULTS: In our sample, bruxism featured the highest prevalence rate, whereas atypical swallowing displayed the highest rate among predisposing factors. CONCLUSION: We therefore recommend that the evaluation of possible TMD signs and symptoms in children be adopted as routine in the initial clinical examination.

Aglossia: Case Report

Introduction Aglossia is a rare condition caused by failure of the tongue embryogenesis process (in the fourth to eighth weeks of gestation). The tongue is an organ used in different activities such as sucking, swallowing, chewing, and talking. It is also responsible for shaping palate dental arches (in its absence, they become atrophic). There are few similar cases reported in the literature. Objective To describe a rare case of aglossia and the multidisciplinary professionals working together for 5 years to treat the patient. Resumed Report An 8-year-old girl with aglossia had an assessment comprising: (1) clinical assessment of the stomatognathic system related to resting posture, tonus, and mobility; (2) orthodontic assessment; (3) surface electromyography of the chewing muscles; (4) swallowing videofluoroscopy. Conclusion The authors confirmed the need of multidisciplinary cooperation to improve the patients quality of life, because agenesia implicates many activities/functions that depend on the tongue to fully work. Multiprofessional cooperation helps the patient learn compensation mechanisms.

Does Body Mass Index Interfere in the Formation of Speech Formants

Introduction  Studies in the fields of voice and speech have increasingly focused on the vocal tract and the importance of its structural integrity, and changes in the anatomy and configuration of the vocal tract determine the variations in phonatory and acoustic measurements, especially in the formation of the formants (Fs). Recent studies have revealed the functional consequences arising from being overweight and having an accumulation of fat in the pharyngeal region, including obstructive sleep apnea syndrome (OSAS) and impacts on the voice. Objectives  To assess the relationship between body mass index (BMI) and analysis of the speech. Methods  This study was approved by the Ethics Committee of the Universidade Federal de São Paulo (no. 288,430). The cohort consisted of 124 individuals aged between 18 and 45 with full permanent dentition and selected randomly. The participants underwent a brief medical history taking, BMI assessments and recording emissions of the sustained vowels /a/, /ε/, /i/, and /u/ by acoustic program PRAAT (v. 5.3.85, Boersma and Weenink, Amsterdam, Netherlands). Recordings were taken using a unidirectional microphone headset (model Karsect HT-9, Guangdong, China), with a condenser connected to an external sound card (USB-SA 2.0, model Andrea, PureAudio™, Pleasant Grove, UT, USA), to reduce noise. Results  There was a significant correlation between BMI and formant 3 (F3) vowel /a/; however, there was a low degree of correlation intensity. Conclusions  We did not observe a correlation between the BMI and the speech formants, but we believe there is a trend in this correlation that leads to changes in speech patterns with increases in BMI.

Relationship between maximum bite force and the gonial angle in crossbite

Introduction: Modification of overjet and posterior crossbite (PC) can affect the maximum bite force (MBF), in turn affecting the shape of the gonial angle (GA). Aims: To analyze MBF in PC and the correlation between MBF and GA in adults. Method: The evaluation was performed in 160 individuals, i.e., 88 men and 72 women (aged 18 to 39 years), divided into two groups: without PC, comprising 130 individuals (75 men and 55 women) and with PC, comprising 30 individuals (13 men and 17 women). The method consisted of the following steps: anamnesis, evaluation of the occlusion, MBF evaluation, and GA measurement. Evaluation of the occlusion was performed in order to classify the occlusion as with or without PC. The MBF was measured with a digital dynamometer [DDK/M model (Kratos, São Paulo, Brazil)]. Three measurements were performed in all individuals with the device positioned on the occlusal surface of the first molars, alternating with one-minute intervals, following which the means were calculated. GA measurement was performed with a goniometer on both, the right and left sides. The data collected were analyzed statistically by parametric tests, considering a significance level of 0.05 (5%). Results: MBF was higher for men, independent of the group and the side; in the group without PC, MBF was different between the sides just for women. Between the groups, MBF was higher for men in the group without PC. The correlation found between MBF and GA in both groups was negative or inversely proportional. Conclusions: The group with PC showed lower MBF in men and the correlation between MBF and GA was negative, suggesting that higher the MBF, the lower is the GA or vice versa. Correspondence to: Silvana Bommarito, Speech therapist; Associate professor, Department of Speech Pathology, Universidade Federal de São Paulo – UNIFESP/EPM, São Paulo, Brazil, E-mail: bomarito@terra.com.br

Study of the electrical activity of muscles: Masseter, temporal and supra-hyoid during swallowing

Objective: To characterize the electrical activity of the muscles: temporal (anterior portion), masseter and suprahyoid muscles during swallowing and to analyze the difference between the sexes. Methods: 61 electromyographic examinations were performed. Among the exams evaluated, 40 individuals (65.6%) were female and 21 (34.4%) were male. The mean age of the volunteers was 23.77 years with standard deviation (SD) of +/6.44 years. The muscles: temporal (anterior portion), masseter and suprahyoid muscles were evaluated bilaterally in the following tests: habitual rest and swallowing of 10 ml of water. The Mann-Whitney test was used to verify the difference between the sexes. The significance was 5% (p <0.05). Results: The results of this study demonstrated that there is a greater participation of the suprahyoid muscles during swallowing, not excluding the participation of the masseter and temporal muscles (anterior portion). During water swallowing, there was participation of the temporal (anterior portion), masseter and especially of the suprahyoid muscles. In the comparison to activity in the male and female sexes, during rest and swallowing, there was greater electrical activity for the female sex. Conclusion: During the swallowing of water there was participation of the temporal muscles (anterior portion), masseter and mainly of the suprahyoid muscles. In the comparison of activity in the male and female sexes, during rest and swallowing, there was greater electrical activity in the female sex. Correspondence to: Silvana Bommarito, Departamento de Fonoaudiologia, Universidade Federal de São Paulo, Rua Botucatu, 802 São Paulo 04023-062, São Paulo, Brazil, E-mail: bomarito@terra.com.br