Orthodontic intervention combined with myofunctional therapy increases electromyographic activity of masticatory muscles in patients with skeletal unilateral posterior crossbite.

OBJECTIVE: The aim of this study was to evaluate the electromyographic activity of both the temporalis and masseter muscles and the mastication type of patients with skeletal unilateral posterior crossbite before and after orthodontic treatment and speech therapy. METHODS: A total of 14 patients with skeletal unilateral posterior crossbite (eight females and six males), between 6-13 years of age, underwent electromyographic evaluation of their masseter and temporalis muscles in mandibular rest, habitual mastication and isometry. The subjects were assessed with regard to mastication type before and after orthodontic treatment and speech therapy. The data obtained during mandibular rest and habitual mastication were normalized in terms of the mean values of isometry. The Student's t-test was used for paired samples to compare the mean values of electromyographic activity (p < 0.05). RESULTS: The masseters during habitual mastication presented higher electromyographic activity after both treatments (p = 0.0458). There was no significant difference between the contralateral masseters in terms of mandibular rest or habitual mastication before or after either treatment (p > 0.05). During habitual mastication, after the treatments, the temporalis muscle on the malocclusion side showed higher electromyographic activity than the contralateral side (p = 0.0263). Prior to therapy, all of the patients exhibited chronic unilateral mastication (n = 14) and 13 patients exhibited bilateral mastication after treatment. CONCLUSIONS: Orthodontic intervention combined with myofunctional therapy in patients with skeletal unilateral posterior crossbite provided an increase in the electromyographic activity of the masseter and temporalis muscles during mandibular rest and habitual mastication, with predominantly bilateral mastication.

Videofluoroscopic evaluation of mastication and swallowing in individuals with TMD.

UNLABELLED: To study mastication and swallowing disorders in patients with temporomandibular disorders (TMD). OBJECTIVE: To investigate mastication and swallowing disorders in patients with severe TMD referred to surgery. MATERIALS AND METHODS: Clinical and experimental study involving ten individuals with TMD submitted to deglutition videofluoroscopy. These patients did not have posterior teeth, mastication pain and food replacement in favor of pasty consistence food. The assessment of the oral and pharyngeal phases approached the following aspects: side of onset and preferential side for chewing, premature escape, remains of food residues in the oral cavity or in the pharyngeal recesses, number of necessary swallowing efforts, laryngeal penetration and/or tracheal aspiration. RESULTS: During mastication and the oral phase we observed tongue compensatory movements upon chewing (n = 7; 70%), premature escape (n = 4; 40%), food remains in the cavity after swallowing (n = 5; 50%) and an excessive number of deglutition efforts (n = 5; 50%). On the pharyngeal phase we observed food remains in the valleculae (n = 6; 60%), in the pyriform sinuses (n = 4; 40%); laryngeal penetration (n = 1; 10%) and tracheal aspiration (n = 4; 40%). CONCLUSION: TMD patients may have alterations in their chewing and swallowing patterns, with laryngeal penetration and/or tracheal aspiration. The study indicates the need for a multidisciplinary assessment because of dysphagia in TMD patients.

Características da função mastigatória em indivíduos com mordidacruzada posterior unilateral / Masticatory function characteristics in individuals with unilateralposterior crossbite

Objetivo: Analisar as características da função mastigatória em indivíduos com mordida cruzada posterior unilateral. Material e métodos: A amostra foi dividida em 2 grupos: grupo 1, composto por 12 indivíduos com mordida cruzada posterior unilateral; e grupo 2, com 11 indivíduos com oclusão normal. Os participantes do estudo foram examinados por ortodontista e fonoaudióloga para identificar as características clínicas da oclusão bem como da função mastigatória e de hábitos de sucção e deglutição. Resultados: No Grupo 1, 5 (41,67%) pacientes apresentaram maloclusão Classe I de Angle; 6 (50%), maloclusão Classe II; e 1 (8,33%), Classe III. Não houve diferença estatisticamente significante entre os grupos para as variáveis uso de chupeta e/ou hábitos bucais, posição de língua durante a deglutição e trituração total do bolo alimentar (p ≥ 0,05). Houve diferença estatisticamente significante entre os grupos para a dificuldade de mastigar alimentos fibrosos (p = 0,0033). Conclusão: A mordida cruzada posterior unilateral foi observada em pacientes com os três tipos de classificação oclusal sagital. Esteve associada à dificuldade de mastigar alimentos fibrosos, não alterando, entretanto, o resultado final da trituração do bolo alimentar.

Objective: To analyze masticatory function characteristics in subjects with unilateral posterior crossbite. Materials and methods: The sample was divided in two groups: group 1, comprised of 12 subjects with unilateral posterior crossbite; and group 2, with 11 subjects with normal occlusion. They were examined by orthodontist and speech therapist to identify clinical characteristics of occlusion, masticatory function, and sucking and swallowing habits. Results: In Group 1 it was observed that 5 (41.67%) patients had Angle Class I malocclusion, 6 (50%), Class II malocclusion, and 1 (8.33%), Class III. There was no statistically significant difference between groups for the following variables: use of pacifier and/or oral habits, tongue position during swallowing and total crushing the bolus (p ≥ 0.05). There was statistically significant difference between groups for difficulty in chewing fibrous foods (p = 0.0033). Conclusion: The unilateral posterior crossbite was observed in patients with three types of sagittal occlusal classification. It was associated with difficulty in chewing fibrous foods, not changing, however, the final result of crushing the bolus.

Avaliação videofluoroscópica da mastigação e deglutição em indivíduos com disfunção temporomandibular (DTM) / Videofluoroscopic evaluation of mastication and swallowing in individuals with TMD

Estudar os distúrbios da mastigação e deglutição na Disfunção Temporomandibular (DTM). OBJETIVO: Investigar as disfunções de mastigação e deglutição na DTM em grau grave, com indicação cirúrgica. MATERIAIS E MÉTODOS: O estudo clínico e experimental verificou dez indivíduos com DTM, submetidos à videofluoroscopia da deglutição. Verificou-se ausência de dentes posteriores, dor em músculos da mastigação e substituições de alimentos, privilegiando-se consistências pastosas. A avaliação das fases oral e faríngea abordou os seguintes aspectos: lado de início e lado preferencial para mastigação, escape prematuro, permanência de resíduos alimentares na cavidade oral e recessos faríngeos, número de deglutições necessárias, presença de penetração laríngea e/ou aspiração traqueal. RESULTADOS: Durante a mastigação e fase oral, observaram-se movimentos compensatórios de língua à mastigação (n = 7; 70%), escape prematuro (n = 4; 40%), resíduos na cavidade após a deglutição (n = 5; 50%) e número excessivo de deglutições (n = 5; 50%). Na fase faríngea, observou-se permanência de resíduos em valécula (n = 6; 60%), resíduos em seios piriformes (n = 4; 40%); penetração laríngea (n = 1; 10%) e aspiração traqueal (n = 4; 40%). CONCLUSÃO: Pacientes com DTM podem apresentar alterações nos padrões de mastigação e deglutição, com penetração laríngea e/ou aspiração traqueal. O estudo indica a necessidade de avaliação multidisciplinar devido à presença de disfagia em pacientes com DTM.

To study mastication and swallowing disorders in patients with temporomandibular disorders (TMD). OBJECTIVE: To investigate mastication and swallowing disorders in patients with severe TMD referred to surgery. MATERIALS AND METHODS: Clinical and experimental study involving ten individuals with TMD submitted to deglutition videofluoroscopy. These patients did not have posterior teeth, mastication pain and food replacement in favor of pasty consistence food. The assessment of the oral and pharyngeal phases approached the following aspects: side of onset and preferential side for chewing, premature escape, remains of food residues in the oral cavity or in the pharyngeal recesses, number of necessary swallowing efforts, laryngeal penetration and/or tracheal aspiration. RESULTS: During mastication and the oral phase we observed tongue compensatory movements upon chewing (n = 7; 70%), premature escape (n = 4; 40%), food remains in the cavity after swallowing (n = 5; 50%) and an excessive number of deglutition efforts (n = 5; 50%). On the pharyngeal phase we observed food remains in the valleculae (n = 6; 60%), in the pyriform sinuses (n = 4; 40%); laryngeal penetration (n = 1; 10%) and tracheal aspiration (n = 4; 40%). CONCLUSION: TMD patients may have alterations in their chewing and swallowing patterns, with laryngeal penetration and/or tracheal aspiration. The study indicates the need for a multidisciplinary assessment because of dysphagia in TMD patients.

Osteogenic sarcoma of the maxilla: case report

Osteosarcoma (OS) is one of the most common primary malignant bone neoplasms, which predominantly occurs in the long bones and rarely in the maxillofacial area. We present a rare case of maxillary OS early diagnosed in a 17-year-old girl through clinical, radiological and histological examination. The treatment involved surgical resection of the tumor followed by radiation therapy and chemotherapy. The patient was much younger than the average age of presentation of a jaw tumor, which typically presents in the third to fourth decades of life. Although there is a consensus in the literature that OS of the jaws is less aggressive and less prone to metastasis than OS of the long bones, that was not true in this case, where in spite of early diagnosis and treatment the patient died due to brain metastasis.

Avaliação laringológica e perceptivo-auditiva vocal nas fases pré e pós-aplicação da técnica de vibração sonora de pregas vocais na leucoplasia plana / Laryngological and vocal auditory-perceptual evaluations pre and post vocal folds vibration in plane leukoplasia

Objetivo: verificar a qualidade vocal, bem como os achados laringológicos nas fases pré e pós-tratamento fonoterápico e orientação clínica otorrinolaringológica em pacientes portadores de leucoplasia plana. Métodos: foram avaliados sete indivíduos com leucoplasia plana (LP), totalizando dez placas, por meio de videolaringoestroboscopia no pré e pós-tratamento fonoterápico e orientação clínica para análise comparativa dos laudos. As amostras vocais foram colhidas nas fases pré e pós-fonoterapia e orientação clínica e gravadas em fita cassete. Foi aplicada a técnica de vibração sonora das pregas vocais pelo período de um mês, e também realizadas as orientações clínicas otorrinolaringológicas. Quatro fonaudiólogas realizaram a análise perceptivo-auditiva, utilizando a escala GRBAS, adotando-se o critério de prevalência da maioria das opiniões para a análise dos resultados da escala. Conclusão: a soprosidade apresentou melhora em 100% , a rouquidão 85%, aspereza 71%, a tensão 28% e a astenia não foi evidenciada. Concluímos que a aplicação da técnica de vibração sonora de pregas vocais associada às orientações clínicas otorrinolaringológicas contribuíram para a melhora da qualidade vocal e para a remissão da leucopenia plana.