Validação do conteúdo de um protocolo de avaliação da motricidade orofacial em lactentes / Content validation of an orofacial myofunctional assessment protocol for infants / Validación del contenido de un protocolo para la evaluación de la motricidad orofacial en bebés

Introdução: Muitos estudos têm se dedicado a compreender melhor a dinâmica da avaliação das estruturas e funções estomatognáticas de lactentes; até a presente pesquisa não foram encontrados estudos específicos para essa faixa etária, até recentemente. Objetivo: Validar o conteúdo de um instrumento fonoaudiológico de avaliação da motricidade orofacial para lactentes na faixa etária de um mês a dois anos. Metodologia: Foi elaborado o instrumento para "avaliação fonoaudiológica da motricidade orofacial de lactentes de um mês a dois anos" a partir dos dados obtidos na literatura. A validação do conteúdo do instrumento se deu por meio da avaliação de quatro juízes para clareza dos itens propostos no protocolo e da representatividade dos mesmos no processo de validação do conteúdo. Os juízes classificaram cada item quanto à clareza, a partir de uma escala tipo Likert de quatro pontos, sendo: (4) muito claro, (3) claro, (2) pouco claro, (1) sem clareza, com o propósito de realizar a validação do conteúdo por meio da aplicação da equação do Índice de Validação do Conteúdo (IVC). Resultados: O protocolo desenvolvido possui 8 itens e uma breve anamnese: Hábitos Orais; Avaliação Estrutural; Respiração; Voz; Avaliação Funcional; Alimentação e Deglutição - líquidos e alimentos em pedaços; Diagnóstico Fonoaudiológico. A etapa seguinte contou com a análise da representatividade e para clareza dos itens do protocolo pelos juízes, e após a segunda análise, a validação do conteúdo resultou na permanência dos 8 itens com Índice de Validade de Conteúdo total de 100%. Conclusão: O conteúdo do protocolo foi considerado válido para uso na avaliação do público-alvo, comprovado por profissionais com experiência na área. A versão final do Protocolo de avaliação fonoaudiológica da motricidade orofacial de bebês foi finalizada com 8 itens de avaliação. (AU)

Introduction: The instruments for evaluating the structures and functions of the stomatognathic system in babies have been lacking in studies. Objective: To validate the content of a speech-language instrument to assess orofacial motricity for babies aged between one month and two years old. Methodology: The instrument for "speech-language assessment of the orofacial motricity of babies from one month to two years old" was created based on the data obtained by the integrative review. The instrument's content was validated through the evaluation of four judges. The judges classified each item according to clarity, based on a four-point Likert scale, as follows: (4) very clear, (3) clear, (2) lightly clear, (1) unclear, to perform content validation by applying the Content Validation Index (CVI) equation. Results: The developed protocol has eight items and a brief anamnesis: Oral Habits; Structural Assessment; Breathing; Voice; Functional Assessment; Feeding and Swallowing - liquids and food in pieces; and Speech-Language Diagnosis. The next step included the analysis of the representativeness of the protocol items by the judges. After the second analysis, the validation of the content resulted in the permanence of the eight items with a total Content Validity Index of 100%. Conclusion: The content of the protocol was considered valid for use in the evaluation of the target audience, proven by people with experience in the area. The final version of the Protocol for the Speech-Language Pathology Assessment of Orofacial Motricity in Babies was completed with eight assessment items. (AU)

Introducción: Los instrumentos para la evaluación de las estructuras y funciones del sistema estomatognático en los bebés han mostrado falta de estudios. Objetivo: Validar el contenido de un instrumento de fonoaudiología para la evaluación de la motricidad orofacial en bebés de un mes a dos años de edad. Metodología: Inicialmente, se llevó a cabo la elaboración del instrumento para la "evaluación logopédica de la motricidad orofacial de bebés de un mes a dos años de edad" propiamente dicho, a partir de los datos obtenidos por la revisión integradora. La validación del contenido del instrumento se realizó a través de la evaluación de cuatro jueces. Los jueces calificaron cada ítem en términos de claridad, utilizando una escala de Likert de cuatro puntos, de la siguiente manera: (4) muy claro, (3) claro, (2) poco claro, (1) poco claro, con el propósito de realizar la validación de contenido a través de la aplicación de la ecuación del Índice de Validación de Contenido (CVI). Resultados: después de la lectura y discusión de los artículos, fue posible desarrollar el protocolo que contiene 8 ítems y una breve anamnesis, que son: Hábitos Orales; Evaluación Estructural; Respiración; Voz; Evaluación Funcional; Alimentación y deglución: líquidos y alimentos en trozos; y; Diagnóstico de Patología del Habla-Lenguaje. El siguiente paso fue el análisis de la representatividad de los ítems del protocolo por parte de los jueces, y luego del segundo análisis, la validación de contenido resultó en la permanencia de 8 ítems con un Índice de Validez de Contenido total del 100%. Conclusión: El contenido del protocolo se consideró válido para su uso en la evaluación del público objetivo, confirmado por personas con experiencia en el área. La versión final del Protocolo de evaluación de la patología del habla y el lenguaje para la motricidad orofacial en bebés se completó con 8 ítems de evaluación. (AU)

Protocolos fonoaudiológicos de história clínica: revisão integrativa / Clinical history speech-language pathology protocols: integrative review

RESUMO Objetivo identificar, coletar e analisar, na literatura científica, evidências da existência de protocolos fonoaudiológicos de levantamento da história clínica, conforme classificação de risco, especialmente para distúrbios oromiofuncionais, em lactentes e pré-escolares. Estratégia de pesquisa foram selecionados estudos publicados, sem delimitação temporal, nas bases de dados eletrônicas LILACS, SciELO e PubMed e na literatura cinza (Google Acadêmico). Critérios de seleção estudos disponíveis na íntegra nas línguas portuguesa e inglesa, que identificassem protocolos fonoaudiológicos de história clínica aplicáveis a lactentes (6 a 23 meses de vida) e pré-escolares (24 a 71 meses de vida). Foram excluídas as revisões narrativas e de literatura (integrativa, sistêmica e escopo). Resultados foram encontradas 1371 publicações brasileiras no período de 1980 a 2022. Destas, foram identificadas apenas cinco que tratavam de protocolos fonoaudiológicos para levantamento de dados pregressos a partir da história clínica da faixa etária de 6 a 71 meses. Apenas um desses protocolos possuía classificação de risco para distúrbios fonoaudiológicos, distribuídos na área de linguagem e fluência. Os outros três eram da área de motricidade orofacial (MO) e não continham classificação de risco para distúrbio miofuncional orofacial. Conclusão existem poucos protocolos fonoaudiológicos para levantamento da história clínica de lactentes e pré-escolares que contenham, ou não, classificação de risco, publicados em revistas de acesso aberto e que passaram por processos completos de validação, sendo necessário ampliar estudos e publicações desses instrumentos, inclusive na área de MO.

ABSTRACT Purpose to identify, collect and analyze in the scientific literature evidence of the existence of speech therapy protocols for collecting clinical history, according to risk classification, especially for oromyofunctional disorders, in infants and preschoolers. Research Strategy We selected published studies, without temporal delimitation, in the electronic databases LILACS, SciELO and PUBMED; and in the gray literature (Google Academic). Selection criteria available in full in Portuguese and English, which identify speech-language pathology protocols of clinical history applicable to infants (6 to 23 months of age) and preschoolers (24 to 71 months of age). Narrative and literature reviews (integrative, systemic, and scope) were excluded. Results 1371 Brazilian publications were found in the period from 1980 to 2022. Of these, only five publications on speech therapy protocols were identified for collecting previous data from the clinical history of the age group between 6 and 71 months. Only two of these protocols have a risk classification for speech-language disorders, distributed in the areas of language and fluency. The other three are from the Orofacial Motricity (OM) area and do not carry a risk classification for orofacial myofunctional disorder. Conclusion There are few speech therapy protocols for surveying the clinical history of infants and preschoolers, whether or not they contain risk classification, published in open access journals that have a complete validation process.Therefore there is a need for more research and publication of these instruments, including in the area of OM.

Surgical Treatment of Oromandibular Limb Hypogenesis Syndrome Type I A by Distraction Osteogenesis Combined With Orthodontic Rehabilitation.

ABSTRACT: Oromandibular limb hypogenesis syndrome is a rare developmental anomaly and only a few cases are reported with complete surgical and orthodontic rehabilitation. An adult male patient with isolated hypoglossia, micrognathism, hypodontia, (oromandibular limb hypogenesis syndrome type I A) was treated with a combination of distraction osteogenesis and orthodontic intervention. The patient was followed up for the duration of 6 years from his first visit to 4 years after the surgery. The combined procedure resulted in successful and satisfactory treatment of the patient by restoring facial aesthetics, occlusal balance, and functional harmony. However, there was not enough tongue enlargement due to late surgical intervention. The objective of this report is to describe the etiology of hypoglossia, the consequences for oral function, and to share our experience from the oral rehabilitation during the treatment procedure.

Mapping of supernumerary elements in patients seeking orthodontic treatment

Dimension, number and shape alterations are frequently observed dental anomalies. Objective: The aim of this study was to map the frequency, the preferred location and the most prevalent types of supernumerary teeth, in the studied population. In addition, to assess the interference that supernumerary teeth may cause in the ectopic eruption of the normal dental series teeth. Methods: This is an observational retrospective study. Data collection was performed by evaluation of dental records of patients treated in an orthodontic clinic. Patients' radiographs, photographs and gypsum dental models were analyzed and data recorded in protocol files, by previously trained undergraduate and postgraduate students. Records from 1984 to 2019 were evaluated, and evaluation lasted two months. Data were stored in Microsoft Office Excel (version 2016) for descriptive analysis. Results: From the 920 patients' records analyzed, 2.7% presented at least one supernumerary tooth, with preferred location on the anterior maxillary area and mandibular parapremolar area. The most prevalent type was the supplemental tooth, with normal eruption orientation and normal alveolar location. Conclusion: The supernumerary teeth of the studied population showed little interference in the ectopic eruption of the normal dental series. Most of the supernumerary teeth were impacted, and, approximately one third of the supernumerary teeth showed deviated eruptions.

Introdução: Alterações de dimensão, número e forma são anomalias dentárias comumente observadas. Objetivo: O objetivo foi mapear a frequência de dentes supranumerários na população estudada, sua localização preferida e os tipos mais prevalentes. Além disso, avaliar a interferência que os dentes supranumerários podem causar na erupção ectópica da série dental normal. Métodos: A pesquisa possui desenho retrospectivo observacional. A coleta de dados foi realizada pela avaliação de prontuários odontológicos dos pacientes atendidos em uma clínica ortodôntica. Foram analisados radiografias, fotografias e modelos de gesso dental dos pacientes e as informações foram registradas em arquivos de protocolo do estudo. A coleta de dados foi realizada por uma estudante de graduação e uma da pós-graduação, previamente calibradas. A coleta durou dois meses e foram avaliados registros de 1984 a 2019. Os dados foram tratados no programa Microsoft Office Excel (version 2016) com análise descritiva dos dados. Resultados: Dos 920 prontuários analisados, 2,7% apresentavam pelo menos um dente supranumerário, com localização preferida na área superior anterior e na área parapremolar mandibular. O tipo mais prevalente foi o dente suplementar, com orientação de erupção normal e localização alveolar normal. Conclusão: Os dentes supranumerários da população estudada neste estudo mostraram pouca interferência na erupção ectópica da série dental normal. A maioria dos dentes supranumerários estava em posição de impactação. E, aproximadamente um terço dos dentes supranumerários apresentaram desvios de erupção.

Orthognathic Hardware Complications in the Era of Patient-Specific Implants.

BACKGROUND: Patients undergoing orthognathic skeletal correction present with a variety of comorbidities that may affect surgical outcomes. The purpose of this study was to determine how patient risk factors and operative technique contribute to complication rates after orthognathic surgery in the era of patient-specific implants. METHODS: Retrospective cohort analysis was conducted of pediatric patients undergoing Le Fort I osteotomy, bilateral sagittal split osteotomy, and/or genioplasty from 2014 to 2018. Patient risk factors, operative characteristics, and postoperative outcomes were gathered and compared with appropriate statistics. RESULTS: Ninety-four patients met inclusion criteria, with an overall 1-year complication rate of 11.7 percent (11 of 94). Patient-specific mandibular plates are significantly associated with infection (p = 0.009; OR, 8.8), occurrence of any complication (p = 0.003; OR, 8.3), readmission (p < 0.001; OR, 11.1), and reoperation (p < 0.001; OR, 11.4). In patients with syndromes or history of cleft lip/palate, patient-specific mandibular plates are associated with infection (p = 0.006; OR, 10.3), readmission (p < 0.001; OR, 21.6), and reoperation (p < 0.001; OR, 22.9). In multivariate regression controlling for age, sex, syndrome status, and orofacial cleft history, use of patient-specific mandibular plates was associated with infection (p = 0.017; adjusted OR, 12.5), any complication (p = 0.007; adjusted OR, 11.8), readmission (p = 0.001; adjusted OR, 17.9), and reoperation (p = 0.001; adjusted OR, 18.9). CONCLUSIONS: In the era of patient-specific orthognathic surgery, syndromic status and use of patient-specific mandibular plates are associated with increased infection, readmission, and reoperation because of hardware-related complications. The authors' data support increased caution and counseling with use of patient-specific mandibular implants in patients with syndromic status, history of orofacial cleft, and history of previous maxillomandibular surgery given increased risk of hardware-related complications. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Radiographic review of anatomy and pathology of the masticator space: what the emergency radiologist needs to know.

The differential diagnosis of a masticator space (MS) lesion is broad, owing in part to the multiple structures contained within such a small region. It is also because the MS is adjacent to many of the other deep spaces within the head and neck, which can act as gateways for disease spread. Therefore, emergency radiologists must be familiar with anatomy of the MS, as well as adjacent spaces in order to provide an accurate diagnosis to the referring clinician. This article illustrates the anatomy and common pathologies within the MS using a case-based multimodality approach. Common masticator space pathologies can be categorized into inflammatory/infectious, neoplastic, and vasoformative lesions. Important imaging features of MS lesions and patterns of disease spread will be discussed, with the aim of making this complex deep space more approachable in the emergent setting.

Evaluation of Canine Transpositions and Related Dental Anomalies in a Turkish Pediatric Population

Abstract Objective: To investigate the prevalence and characteristics of canine transpositions and to evaluate associated dental anomalies in a pediatric population. Material and Methods: This study was carried out by evaluating the panoramic radiographs of 11.750 patients ranging in ages from 6 to 17 presented to a pedodontic clinic over 5 years. The patients with canine transposition were included in the study. Age at diagnosis, gender, classification and location of transposition, presence of other dental anomalies were recorded. Differences were analyzed using the Chi-squared test. Results: Canine transposition was detected in 73 teeth from 69 patients (0.6%). Transpositions were more common in girls than in boys (55.1%). Transposed canine teeth were more frequently observed unilaterally (89%). The most commonly found transposition type was type 2 (42%). A total of 49.3% of 69 patients had retained primary canine teeth, 20.3% had congenitally missing teeth, and 11.6% had peg-shaped, microdont lateral incisors. Impacted teeth excluding third molars and taurodontism were also observed. Conclusion: Although the canine transpositions are generally asymptomatic in children in the period of growth and development, the importance of early diagnosis is crucial to prevent various clinical problems.

Stafne bone defects radiographic features in panoramic radiographs: Assessment of 91 cases

Background: To evaluate 91 cases of Stafne bone defect (SBD) in panoramic radiographs (PR) to determine the prevalence of different SBD variants, considering age, gender, and side. Additionally, to assess the most frequent imaging features of SBD. Material and Methods: Participant data were collected from 91 SBD cases with PR imaging. First, SBDs were classified according to their location, as anterior, posterior, or ramus variant. SBD imaging features were classified according to radiographic imaging findings, assessing margins, degree of internal radiolucency, shape, topographic relationship between the defect and mandibular border, location of the defect according to mandibular teeth, and locularity. The topographic relationship between the SBD and the mandibular canal was described for the inferior variant only. Mean sizes were also described. Results: A total of 92 SBD cases were evaluated from 91 radiographs. One case presented multiple defects. Mean patient age was 60.80 years. Men were more affected than women. The most frequent SBD variant was the posterior variant, and the least frequent was the ramus variant. The most observed radiographic features were thick sclerotic bone margin in the entire contour of the defect, partially radiolucent internal content, oval shape, continuity with mandible base without discontinuity of mandible border, third molar region location, and unilocular shape. With the posterior variant only, the most common topographic relationship between the defect and the upper wall of the mandibular canal was the defect located below the upper wall and continuous with the inferior wall of the mandibular canal. Conclusions: The knowledge of common SBD radiographic imaging features in PR can help dental practitioners with the differential diagnosis of SBD

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Tratamiento de las anomalías dentomaxilofaciales con bloques gemelos estándar / Treatment of dentomaxillofacial anomalies with standard twin blocks

Introducción: el sistema de bloques gemelos es una consecuencia natural de la evolución del tratamiento con aparatos funcionales y representa una transición fundamental de los aparatos de una sola pieza, que restringen la función anormal, a los aparatos que favorecen la función normal. Objetivo: evaluar los resultados del tratamiento de las anomalías dentomaxilofaciales con bloques gemelos estándar. Método: se realizó un estudio cuasi-experimental modalidad antes y después sin grupo control, en 10 pacientes que fueron ingresados en la consulta de ortodoncia de la Clínica Universitaria de Especialidades Estomatológicas Manuel Cedeño, entre noviembre de 2016 a enero de 2018, a los que se instalaron aparatos bloques gemelos estándar y se determinaron los cambios obtenidos a los 9 meses de iniciada la etapa activa del tratamiento mediante el examen clínico y el análisis cefalométrico de las telerradiografías laterales del cráneo. Resultados: se corrigió la posición mandibular en el 80 por ciento de los pacientes, la clasificación esqueletal clase II y el resalte se modificó en el 90 por ciento y 70 por ciento; respectivamente, así como una mejoría del perfil en el 60 por ciento; con una significación estadística de p= 0,000. Conclusiones: se produjeron favorables cambios clínicos y cefalométricos, así como un resalte y perfil adecuado, que influyeron en el mejoramiento de la oclusión y la estética de los pacientes(AU)

Introduction: the twin block system is a natural consequence of the evolution of the treatment with functional devices and represents a fundamental transition from single-piece devices, whichrestrict abnormal function, to devices that favor normal function. Objective: to evaluate the results of the treatment of dentomaxillofacial anomalies with standard twin blocks. Method: we performed a quasi-experimental modality before and after without a control group, in 10 patients who were admitted to the orthodontic clinic of the University Clinic of Stomatological Specialties Manuel Cedeño, from November 2016 to January of 2018, to which standard twin blocks were installed and the changes obtained 9 months after the start of the active treatment phase were determined by means of the clinical examination and the cephalometric analysis of the lateral cranioradiographies of the skull.Results: the mandibular position was corrected in 80 percent of the patients, the class II skeletal classification and the projection was modified in 90 percent and 70 percent; respectively, as well as an improvement of the profile in 60 percent; with a statistical significance of p = 0.000. Conclusions: there were favorable clinical and cephalometric changes as well as an adequate profile and prominence, which influenced the improvement of the occlusion and the aesthetics of the patients(EU)

La relació de la micrognàtia transversal amb alguns factors de risc en infants mexicans / Micrognatismo transversal y su relación con algunos factores de riesgo en niños mexicanos / Risk factors of transversal micrognathiain mexican children

Fonament: La micrognàtia transversal (MT) és una alteració del creixement ossi i de la relació dental que impedeix el funcionament adequat de l'aparell masticatori. Objectiu: Avaluar si hi ha associació entre la freqüència d'MT amb la lactància materna de menys de sis mesos, la presència d'hàbits de succió digital, la respiració bucal i l'absència d'espais fisiològics. Mètode: Es va dur a terme un estudi transversal examinant 273 infants mexicans de cinc anys, de tots dos sexes. Abans de l'enquesta es va estandarditzar un cirurgià dentista (k=0,998). Per al tractament estadístic es van calcular freqüències i percentatges, i la prova de khi quadrat corregida de Yates. Resultats: La condició clínica més freqüent va ser l'absència d'espais fisiològics (62,3%); així mateix, l'MT va tenir una distribució variable per sexe, prò no significativa. Es va observar associació entre l'MT amb l'absència d'espais fisiològics, l'hàbit de respiració bucal, la lactància i la mossegada profunda (X 2 Y =10,311, p =0,0001; X 2 Y =7,290, p=0,0001; X 2 Y =21,374, p =0,0001; X2 Y =8,127, p =0,044, respectivament), però no amb la succió digital. Conclusions: Els resultats d'aquest estudi posen de manifest el paper rellevant del pediatre per recomanar a les mares que alletin els seus fills durant un període no menor a sis mesos, així com la responsabilitat d'identificar i eradicar les causes que provoquen que l'infant respiri per la boca, a més de fer la derivació a l'odontopediatre en el cas que ho consideri necessari, perquè elimini aquest hàbit, com a mesura de prevenció per al desenvolupament de maloclusions dentals

Fundamento: El micrognatismo transversal (MT) es una alteración del crecimiento óseo y de la relación dentaria que impiden el funcionamiento adecuado del aparato masticatorio. Objetivo: Evaluar si existe asociación entre la frecuencia de MT con la lactancia materna menor a seis meses, la presencia de hábitos de succión digital, la respiración bucal y la ausencia de espacios fisiológicos. Método: Se llevó a cabo un estudio transversal examinando a 273 niños mexicanos de cinco años, de ambos sexos. Previamente a la encuesta, se estandarizó a un cirujano dentista ( k =0,998). Para el tratamiento estadístico fueron calculados frecuencias y porcentajes, y la prueba de ji cuadrado corregida de Yates. Resultados: La condición clínica más frecuente fue la ausencia de espacios fisiológicos (62,3%); asimismo, el MT tuvo una distribución variable por sexo, pero no significativa. Se observó asociación entre el MT con la ausencia de espacios fisiológicos, el hábito de respiración bucal, la lactancia y la mordida profunda (X 2Y=10,311, p=0,0001; X2Y=7,290, p=0,0001; X2Y=21,374, p=0,0001; X2Y=8,127, p=0,044, respectivamente), pero no con la succión digital. Conclusiones: Los resultados del resente estudio ponen de manifiesto el papel relevante del pediatra para recomendar a las adres que amamanten a sus hijos durante un periodo no menor a seis meses, así omo la responsabilidad de identificar y erradicar las causas que provocan que el niño espire por la boca, además de su derivación al odontopediatra en el caso de que lo onsidere necesario, para que elimine este hábito como medida de preven-ción para el esarrollo de maloclusiones dentales

Background: Transversal micrognathia (TM) is an alteration of bone growth and the dental distribution that affects the adequate function of masticatory apparatus. Objective: To evaluate the association between the frequency of transversal micrognathia and breastfeeding less than six months, the presence of thumb sucking habits, oral breathing, and the absence of physiological spaces. Method: We conducted a transversal study including 273 five- years-old Mexican children of both sexes. Prior to the survey, we standardized the evaluation by a dental surgeon ( k=0.998). We calculated frequencies and percentages, and applied the chi-squa-red test with Yates correction. Results: The most frequent clinical condition found was the absence of physiological spaces (62.3%). TM had a variable but not significant sex distribution. We observed an association between TM and the absence of physiological spaces, oral breathing, breastfeeding, and deep biting (X2Y=10,311, p=0,0001; X2Y=7,290, p=0,0001; 2Y=21,374, p=0,0001; X2Y=8,127, p=0,044, respec-tively), but not with thumb sucking. Conclusions: Our results highlight the relevant role of the pediatrician in advising others that breastfeed their children for periods shorter than six months, as well as the esponsibility to identify and eradicate the factors that cause oral breathing and rompt evaluation by a pediatric dentist when required to prevent the de-velopment of dental malocclusion

Intervalo de confianza para las normas del cefalograma resumido de Ricketts en niños de cubanos / Confidence interval for the standards of the Ricketts´summarized cephalogram in Cuban children

Introducción: en hallazgos cefalométricos de diferentes países en poblaciones conpatrones de crecimientos y oclusión normal, se reportan diferencias estadísticamentesignificativas a los valores dados en los cefalogramas de Ricketts, Steiner, Downs,Jarabak y otros. En Cuba no existen estudios de estos patrones en niños con denticiónmixta los que favorecerían un mejor diagnóstico de las anomalías dento-maxilofaciales.Objetivo: proponer el perfeccionamiento de las normas del cefalograma resumido deRicketts para los niños.Materiales y Métodos: investigación observacional, descriptiva en cuatropoblaciones pertenecientes a las siguientes zonas del país: Matanzas, Cárdenas,Camagüey y Sancti Spíritus. El universo estuvo constituido por 1 657 niños de 9 añosde edad. La muestra 163 niños, seleccionados por el método estratificado porconglomerados con oclusión dentaria normal. Se utilizó el análisis del cefalogramaresumido de Ricketts y la prueba t de media para determinar los valores de las variables estudiadas y se hicieron estimaciones puntuales y por intervalos deconfianza.Resultados: tres variables mostraron medias iguales a las normas de Ricketts: ejefacial (90°), profundidad facial (87°) y profundidad maxilar (90°). En las restantesfueron comprobadas diferencias significativas. Se obtuvo un intervalo de confianzapara cada una de las variables del cefalograma resumido de Ricketts.Conclusiones: solamente tres variables presentaron valores similares a los planteadospor Ricketts, las restantes presentaron valores que difieren significativamente de losplanteados por Ricketts. Se propone utilizar el intervalo de confianza obtenido en estainvestigación en las variables del cefalograma resumido de Ricketts para diagnosticarlas anomalías dento-maxilofaciales en niños cubanos (AU).

Introduction: in cephalometric findings from different countries in populations withnormal growing and occlusion patterns, significant statistic differences are reported inrelation to the values given in the cephalograms of Ricketts, Steiner, Downs, Jarabak,and others. In Cuba there are not studies of these patterns in children with mixeddentition that might allow a better diagnosis of dental, maxilla-facial anomalies.Objective: to propose the improvement of the standards of the Ricketts abridgecephalogram for children.Materials and methods: descriptive, observational research in four populationsbelonging to different regions of the country: Matanzas, Cárdenas, Camagüey andSancti Spíritus. The universe was formed by 1675 children aged 9 years old; thesample, 163 children with normal dental occlusion, was chosen by the stratifiedmethod per conglomerate. The analysis of the Ricketts summarized cephalogram andthe mean T test were used to determine the values of the studied variables; punctualestimates and estimates by confidence interval were carried out.Results: three variables showed equal means than Ricketts standards: facial axis(90o), facial depth (87o) and maxillary depth (90o). In the remaining variables therewere found significant differences. A confidence interval was obtained for every one ofthe Ricketts summarized cephalogram variable.Conclusions: only three variables showed values similar to those given by Ricketts.The remaining ones presented values significantly differing from those established byRicketts. The proposition is using the confidence interval obtained in this research inthe variables of the Ricketts summarized cephalogram to diagnose the dental-maxillafacial anomalies in Cuban children (AU).

Intervalo de confianza para las normas del cefalograma resumido de Ricketts en niños de cubanos / Confidence interval for the standards of the Ricketts´summarized cephalogram in Cuban children

Introducción: en hallazgos cefalométricos de diferentes países en poblaciones con patrones de crecimientos y oclusión normal, se reportan diferencias estadísticamente significativas a los valores dados en los cefalogramas de Ricketts, Steiner, Downs, Jarabak y otros. En Cuba no existen estudios de estos patrones en niños con dentición mixta los que favorecerían un mejor diagnóstico de las anomalías dento-maxilofaciales. Objetivo: proponer el perfeccionamiento de las normas del cefalograma resumido de Ricketts para los niños. Materiales y Métodos: investigación observacional, descriptiva en cuatro poblaciones pertenecientes a las siguientes zonas del país: Matanzas, Cárdenas, Camagüey y Sancti Spíritus. El universo estuvo constituido por 1 657 niños de 9 años de edad. La muestra 163 niños, seleccionados por el método estratificado por conglomerados con oclusión dentaria normal. Se utilizó el análisis del cefalograma resumido de Ricketts y la prueba t de media para determinar los valores de las variables estudiadas y se hicieron estimaciones puntuales y por intervalos de confianza. Resultados: tres variables mostraron medias iguales a las normas de Ricketts: eje facial (90°), profundidad facial (87°) y profundidad maxilar (90°). En las restantes fueron comprobadas diferencias significativas. Se obtuvo un intervalo de confianza para cada una de las variables del cefalograma resumido de Ricketts. Conclusiones: solamente tres variables presentaron valores similares a los planteados por Ricketts, las restantes presentaron valores que difieren significativamente de los planteados por Ricketts. Se propone utilizar el intervalo de confianza obtenido en esta investigación en las variables del cefalograma resumido de Ricketts para diagnosticar las anomalías dento-maxilofaciales en niños cubanos (AU).

Introduction: in cephalometric findings from different countries in populations with normal growing and occlusion patterns, significant statistic differences are reported in relation to the values given in the cephalograms of Ricketts, Steiner, Downs, Jarabak, and others. In Cuba there are not studies of these patterns in children with mixed dentition that might allow a better diagnosis of dental, maxilla-facial anomalies. Objective: to propose the improvement of the standards of the Ricketts abridge cephalogram for children. Materials and methods: descriptive, observational research in four populations belonging to different regions of the country: Matanzas, Cárdenas, Camagüey and Sancti Spíritus. The universe was formed by 1675 children aged 9 years old; the sample, 163 children with normal dental occlusion, was chosen by the stratified method per conglomerate. The analysis of the Ricketts summarized cephalogram and the mean T test were used to determine the values of the studied variables; punctual estimates and estimates by confidence interval were carried out. Results: three variables showed equal means than Ricketts' standards: facial axis (90o), facial depth (87o) and maxillary depth (90o). In the remaining variables there were found significant differences. A confidence interval was obtained for every one of the Ricketts' summarized cephalogram variable. Conclusions: only three variables showed values similar to those given by Ricketts. The remaining ones presented values significantly differing from those established by Ricketts. The proposition is using the confidence interval obtained in this research in the variables of the Ricketts' summarized cephalogram to diagnose the dental-maxillafacial anomalies in Cuban children (AU).

Analysis of the stomatognathic system of children according orthodontic treatment needs.

PURPOSE: The present study evaluated electromyographic activity (EMG), masticatory performance, and tongue strength in children without and with orthodontic treatment needs. PATIENTS AND METHODS: A total of 90 children were screened and divided into the following groups: Group I (no treatment needed; mean age: 8.00 ± 0.43 years; n = 26), Group II (few malocclusions, treatment needed; mean age: 8.89 ± 0.43 years; n = 28), and Group III (slight-to-borderline treatment needed; mean age: 8.44 ± 0.22 years; n = 36). Orthodontic treatment need was classified on the basis of IOTN-DHC (Index of Orthodontic Treatment Need - Dental Health Component). The electromyographic Trigno EMG Systems was used for muscle analysis and the Iowa Oral Pressure Instrument (IOPI) was used to measure tongue strength. Data were analyzed using normality tests and one-way analysis of variance with a Bonferroni post hoc test (p ≤ 0.05). RESULTS: EMG in almost all mandibular movements was higher in Group III with statistically significant differences compared to position at rest: right masseter (p = 0.03); protrusion: left temporal (p = 0.02); saliva swallowing: left temporal (p = 0.05) and water swallowing: orbicularis oris mouth, right upper segment (p = 0.05). Lower masticatory performance was found in Group III, but the difference compared to Group I and II was not significant. There were no significant differences between the groups in terms of tongue strength. CONCLUSIONS: Children with borderline orthodontic treatment needs show functional disorders of the stomatognathic system.

Evaluation of stomatognathic problems in children with osteogenesis imperfecta (osteogenesis imperfecta - oi) - preliminary study.

According to epidemiological data, muscular dysfunctions of the masticatory system occur in 15-23% of the population. Preventive examinations of functional disorders of the stomatognathic system are, therefore, of particular importance. A distinct group of patients exposed to dysfunctions in the area of the masticatory organ locomotor apparatus comprises those with genetic diseases characterised by disorders in collagen formation. One of such diseases is osteogenesis imperfecta (OI) and dentinogenesis imperfecta that usually goes together with the former. AIM: The objective of this work was to evaluate the frequency with which particular disorders of the masticatory organ locomotor apparatus occur within the group of patients with osteogenesis imperfecta. MATERIAL AND METHODS: The study was performed on patients of the Orthopaedic Clinic of the Polish-American Paediatric Institute in Kraków. The mean age of the children was 7.9 years. In all the cases, a genetic diagnosis of OI has been confirmed. The research methods were based on an in-depth interview on family diseases, pregnancy, postnatal period, feeding, subjective assessment of dysfunctions in the stomatognathic system. An examination of the deformations in the stomatognathic system and the skeleton was conducted, as well as an examination of the trauma and tone of the jaw. The relationship between breastfeeding and swallowing and speech disorders was also evaluated. The impact of intubation on mandibular ranges was investigated. RESULTS: The results obtained were subjected to statistical analysis on the basis of which conclusions were drawn concerning disorders in the stomatognathic system which tend to occur in children with OI. The renunciation of breastfeeding significantly contributes to sucking and swallowing disorders, rumen disorders, as well as biomechanical disorders in the temporomandibular joint. A significant dependence between breastfeeding and swallowing problems was found, whereas there was no such dependence with respect to speech impediments. CONCLUSIONS: The results of the research conducted led to the following conclusions: 1. Among pediatric patients with OI there are disorders in the stomatognathic system. The most common dysfunctions are: abdominal, swallowing and sucking disorders, abnormal muscle structure of the rumen and biomechanical disorders in the temporomandibular joints. Breastfeeding significantly contributes to swallowing disorders. 2. The therapeutic process involving children with OI requires the cooperation of specialists in orthopedics, pediatrics, physiotherapy, orthodontics and neurologopedics to carry out comprehensive diagnostics and treatment tailored to the individual needs of the patient. 3. In order to draw final conclusions, there is a need for more research by means of objective tools, such as EMG and a condensate recorder.

Pfeiffer syndrome: oral healthcare management and description of new dental findings in a craniosynostosis.

Pfeiffer syndrome is a rare fibroblast growth factor receptor-related craniosynostosis with variable clinical presentations. We describe new dental findings of hypodontia, microdontia, dilacerations, and radicular dentin dysplasia in a 19-year-old girl, and discuss the oral health management.

Efectos del tratamiento osteopático global en sujetos con disfución de la ATML / No disponible

Introducción: Las disfunciones temporomandibulares (DTM) son un conjunto de síntomas y signos donde existe una implicación importante de la musculatura masticatoria en particular de los músculos temporales. Objetivos. Observar los efectos de un tratamiento osteopático global de cuatro sesiones en pacientes con DTM y evaluar las modificaciones de aquellas variables objeto de medición. Material y métodos. Se realizaron cuatro sesiones de osteopatía una vez por semana durante un mes en 9 sujetos con DTM. Se llevaron a cabo mediciones algométricas de los puntos gatillos (PGs) de la musculatura temporal y del masetero, inclinométricas en todos los movimientos cervicales así como mediciones de los movimientos de la articulación temporomandibular (ATM) en abertura, diducción derecha e izquierda, antes de la primera sesión y una semana después de la última sesión recibida Resultados. En el análisis intragrupal se obtuvieron datos estadísticamente significativos en el umbral del dolor a la presión (UDP) del Masetero derecho (MASderecho) (p=0,050), UDP del Temporal derecho TEMdcho) (p=0,035), lateroflexión derecha (SD) (p=0,012) y en la abertura (p=0,008). Y una tendencia a la significación en UDPMASizq (p=0,068). Conclusiones. La terapia osteopática global produce un aumento en el UDP de los PGs de los músculos temporales maseteros derechos, y un aumento de la movilidad en lateroflexión derecha cervical y abertura bucal

No disponible

Computational and clinical investigation on the role of mechanical vibration on orthodontic tooth movement.

The aim of this study is to investigate the biomechanics for orthodontic tooth movement (OTM) subjected to concurrent single-tooth vibration (50Hz) with conventional orthodontic force application, via a clinical study and computational simulation. Thirteen patients were recruited in the clinical study, which involved distal retraction of maxillary canines with 1.5N (150g) force for 12weeks. In a split mouth study, vibration and non-vibration sides were randomly assigned to each subject. Vibration of 50Hz, of approximately 0.2N (20g) of magnitude, was applied on the buccal surface of maxillary canine for the vibration group. A mode-based steady-state dynamic finite element analysis (FEA) was conducted based on an anatomically detailed model, complying with the clinical protocol. Both the amounts of space closure and canine distalization of the vibration group were significantly higher than those of the control group, as measured intra-orally or on models (p<0.05). Therefore it is indicated that a 50Hz and 20g single-tooth vibration can accelerate maxillary canine retraction. The volume-average hydrostatic stress (VHS) in the periodontal ligament (PDL) was computationally calculated to be higher with vibration compared with the control group for maxillary teeth and for both linguo-buccal and mesial-distal directions. An increase in vibratory frequency further amplified the PDL response before reaching a local natural frequency. An amplification of PDL response was also shown to be induced by vibration based on computational simulation. The vibration-enhanced OTM can be described by mild, vigorous and diminishing zones among which the mild zone is considered to be clinically beneficial.