Orofacial myofunctional assessment and quality of life of individuals with Parkinson's disease.

OBJECTIVES: To characterize orofacial myofunctional structures of elders with Parkinson's disease (PD) and examine the relationship with the stages of PD, pharmacotherapy, and quality of life. METHODS: PD Group with 45 elders and a control group (CG) of 10 healthy elders of both sexes were included (60-86 years). Structured interviews, medical records, and clinical examination gathered information on health aspects such as the use of drugs, Hoehn & Yahr stages 1-4, and oral health status. The Mini-Mental State Examination, Parkinson's Disease Questionnaire, and Orofacial Myofunctional Evaluation with Scores for Elders were applied. RESULTS: Better oral health status was found in participants diagnosed as Hoehn & Yahr stage 1 compared to the later stages. OMES-Elders scores for appearance/posture, mobility, breathing, and speech functions were different between groups, and decreased overall OMES-Elders was observed across the Hoehn & Yahr stages. A higher number of masticatory cycles was required for chewing and ingestion of the test food in the PD group compared to CG (p < .05). Significant differences were found in the mobility and daily living activities domains and an overall score of QoL between the Hoehn & Yahr stages 1 and 4, and worst orofacial functioning was accompanied by the worst self-perception of QoL in the communication domain (rho = -0.32; p = .034). The use of xerogenic drugs did not affect the OMES-Elders swallowing domain. CONCLUSION: Worse dental condition and performance of orofacial functions was observed in the elders with PD as the disease progresses, and poorer orofacial performance negatively affects their perception of communication skills.

Effect of speech therapy on quality of life in patients with spinocerebelar ataxia type 3.

BACKGROUND: Individuals with spinocerebellar ataxia type 3 (SCA3) present communication and swallowing disorders, and consequent deterioration in quality of life (QOL). OBJECTIVE: To evaluate the impact of a speech therapy rehabilitation program on the QOL of patients with SCA3. METHODS: All participants were randomly assigned to two groups, an intervention group receiving speech therapy (STG) and a control group (CG). The International Cooperative Ataxia Rating Scale scores were 32.4 ± 20.2, and the Scale for the Assessment and Rating of Ataxia scores were 11.8 ± 8.0. The intervention consisted of a 12-session speech therapy rehabilitation program with oral, pharyngeal, and laryngeal strengthening exercises-the so-called ATAXIA-Myofunctional Orofacial and Vocal Therapy (A-MOVT). They all were submitted to pre- and postintervention evaluations using the World Health Organization's Quality of Life (WHOQOL-BREF) assessment, as well as the Living with Dysarthria (LwD), Quality of Life in Swallowing Disorders (SWAL-QOL), and Food Assessment Tool (EAT-10). RESULTS: The study sample consisted of 48 patients with SCA3 (STG = 25; CG = 23), mean age was 47.1 ± 11.4 years; mean age at symptom onset was 36.9 ± 11.3 years; disease duration was 11.9 ± 13.3 years. After the 3-month intervention, there were significant changes in the QOL in the STG compared with the CG, when assessed by the LwD (179.12 ± 62.55 vs. 129.88 ± 51.42, p < 0.001), SWAL-QOL (869.43 ± 153.63 vs. 911.60 ± 130.90, p = 0.010), and EAT-10 (5.16 ± 7.55 vs. 2.08 ± 3.85, p = 0.018). CONCLUSIONS: Patients with SCA3 should receive continuous speech therapy as part of the A-MOVT program, because therapy helps to improve difficulty swallowing and dysarthria.

ANTECEDENTES: Indivíduos com ataxia espinocerebelar tipo 3 (AEC3) apresentam distúrbios da comunicação e deterioração da deglutição e, consequentemente, na qualidade de vida (QV). OBJETIVO: Avaliar o impacto de um programa de reabilitação fonoaudiológica na QV em pacientes com AEC3. MéTODOS: Todos os participantes foram alocados aleatoriamente em dois grupos, um grupo intervenção que recebeu terapia fonoaudiológica (GTF) e um grupo controle (GC). As pontuações das escalas: International Cooperative Ataxia Rating Scale (ICARS) foram 32,4 ± 20,2 e da Scale for the Assessment and Rating of Ataxia (SARA) foram 11,8 ± 8,0. A intervenção consistiu em um programa de reabilitação fonoaudiológica de 12 sessões composto por exercícios de fortalecimento oral, faríngeo e laríngeo - denominados ATAXIA - Terapia Miofuncional Orofacial e Vocal (A-TMOV). Todos foram submetidos a avaliações pré e pós-intervenção por meio dos protocolos World Health Organization's Quality of Life (WHOQOL-BREF), Vivendo com Disartria (VcD), Quality of Life in Swallowing Disorders (SWAL-QOL) e Food Assessment Tool (EAT-10). RESULTADOS: A amostra foi composta por 48 pacientes com AEC3 (25 no GTF e 23 no GC), média de idade 47,1 ± 11,4anos; média de idade de início dos sintomas 36,9 ± 11,3anos; duração da doença 11,9 ± 13,3anos. Após intervenção de três meses, houve mudanças significativas na QV no GTF em comparação com o GC quando avaliado pelo VcD (179,12 ± 62,55 versus129,88 ± 51,42, p < 0,001), SWAL-QOL (869,43 ± 153,63 versus 911,60 ± 130,90, p = 0,010), EAT-10 (5,16 ± 7,55 versus 2,08 ± 3,85, p = 0,018). CONCLUSõES: Pacientes com AEC3 devem receber terapia fonoaudiológica contínua como parte do programa A-TMOV, pois a terapia ajuda a melhorar a dificuldade de deglutição e a disartria.

Longitudinal analysis of risk factors associated with severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among hemodialysis patients and healthcare personnel in outpatient hemodialysis centers.

In this prospective, longitudinal study, we examined the risk factors for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among a cohort of chronic hemodialysis (HD) patients and healthcare personnel (HCPs) over a 6-month period. The risk of SARS-CoV-2 infection among HD patients and HCPs was consistently associated with a household member having SARS-CoV-2 infection.

Predictors of humoral response to SARS-CoV-2 mRNA vaccine BNT162b2 in patients receiving maintenance dialysis.

Objective: Patients on dialysis are at high risk for severe COVID-19 and associated morbidity and mortality. We examined the humoral response to SARS-CoV-2 mRNA vaccine BNT162b2 in a maintenance dialysis population. Design: Single-center cohort study. Setting and participants: Adult maintenance dialysis patients at 3 outpatient dialysis units of a large academic center. Methods: Participants were vaccinated with 2 doses of BNT162b2, 3 weeks apart. We assessed anti-SARS-CoV-2 spike antibodies (anti-S) ∼4-7 weeks after the second dose and evaluated risk factors associated with insufficient response. Definitions of antibody response are as follows: nonresponse (anti-S level, <50 AU/mL), low response (anti-S level, 50-839 AU/mL), and sufficient response (anti-S level, ≥840 AU/mL). Results: Among the 173 participants who received 2 vaccine doses, the median age was 60 years (range, 28-88), 53.2% were men, 85% were of Black race, 86% were on in-center hemodialysis and 14% were on peritoneal dialysis. Also, 7 participants (4%) had no response, 27 (15.6%) had a low response, and 139 (80.3%) had a sufficient antibody response. In multivariable analysis, factors significantly associated with insufficient antibody response included end-stage renal disease comorbidity index score ≥5 and absence of prior hepatitis B vaccination response. Conclusions: Although most of our study participants seroconverted after 2 doses of BNT162b2, 20% of our cohort did not achieve sufficient humoral response. Our findings demonstrate the urgent need for a more effective vaccine strategy in this high-risk patient population and highlight the importance of ongoing preventative measures until protective immunity is achieved.

Effect of speech therapy on quality of life in patients with spinocerebelar ataxia type 3 / Efeito da terapia fonoaudiológica na qualidade de vida de pacientes com ataxia espinocerebelar tipo 3

Abstract Background Individuals with spinocerebellar ataxia type 3 (SCA3) present communication and swallowing disorders, and consequent deterioration in quality of life (QOL). Objective To evaluate the impact of a speech therapy rehabilitation program on the QOL of patients with SCA3. Methods All participants were randomly assigned to two groups, an intervention group receiving speech therapy (STG) and a control group (CG). The International Cooperative Ataxia Rating Scale scores were 32.4 ± 20.2, and the Scale for the Assessment and Rating of Ataxia scores were 11.8 ± 8.0. The intervention consisted of a 12-session speech therapy rehabilitation program with oral, pharyngeal, and laryngeal strengthening exercises—the so-called ATAXIA-Myofunctional Orofacial and Vocal Therapy (A-MOVT). They all were submitted to pre- and postintervention evaluations using the World Health Organization's Quality of Life (WHOQOL-BREF) assessment, as well as the Living with Dysarthria (LwD), Quality of Life in Swallowing Disorders (SWAL-QOL), and Food Assessment Tool (EAT-10). Results The study sample consisted of 48 patients with SCA3 (STG = 25; CG = 23), mean age was 47.1 ± 11.4 years; mean age at symptom onset was 36.9 ± 11.3 years; disease duration was 11.9 ± 13.3 years. After the 3-month intervention, there were significant changes in the QOL in the STG compared with the CG, when assessed by the LwD (179.12 ± 62.55 vs. 129.88 ± 51.42, p < 0.001), SWAL-QOL (869.43 ± 153.63 vs. 911.60 ± 130.90, p = 0.010), and EAT-10 (5.16 ± 7.55 vs. 2.08 ± 3.85, p = 0.018). Conclusions Patients with SCA3 should receive continuous speech therapy as part of the A-MOVT program, because therapy helps to improve difficulty swallowing and dysarthria.

Resumo Antecedentes Indivíduos com ataxia espinocerebelar tipo 3 (AEC3) apresentam distúrbios da comunicação e deterioração da deglutição e, consequentemente, na qualidade de vida (QV). Objetivo Avaliar o impacto de um programa de reabilitação fonoaudiológica na QV em pacientes com AEC3. Métodos Todos os participantes foram alocados aleatoriamente em dois grupos, um grupo intervenção que recebeu terapia fonoaudiológica (GTF) e um grupo controle (GC). As pontuações das escalas: International Cooperative Ataxia Rating Scale (ICARS) foram 32,4 ± 20,2 e da Scale for the Assessment and Rating of Ataxia (SARA) foram 11,8 ± 8,0. A intervenção consistiu em um programa de reabilitação fonoaudiológica de 12 sessões composto por exercícios de fortalecimento oral, faríngeo e laríngeo - denominados ATAXIA - Terapia Miofuncional Orofacial e Vocal (A-TMOV). Todos foram submetidos a avaliações pré e pós-intervenção por meio dos protocolos World Health Organization's Quality of Life (WHOQOL-BREF), Vivendo com Disartria (VcD), Quality of Life in Swallowing Disorders (SWAL-QOL) e Food Assessment Tool (EAT-10). Resultados A amostra foi composta por 48 pacientes com AEC3 (25 no GTF e 23 no GC), média de idade 47,1 ± 11,4anos; média de idade de início dos sintomas 36,9 ± 11,3anos; duração da doença 11,9 ± 13,3anos. Após intervenção de três meses, houve mudanças significativas na QV no GTF em comparação com o GC quando avaliado pelo VcD (179,12 ± 62,55 versus129,88 ± 51,42, p < 0,001), SWAL-QOL (869,43 ± 153,63 versus 911,60 ± 130,90, p = 0,010), EAT-10 (5,16 ± 7,55 versus 2,08 ± 3,85, p = 0,018). Conclusões Pacientes com AEC3 devem receber terapia fonoaudiológica contínua como parte do programa A-TMOV, pois a terapia ajuda a melhorar a dificuldade de deglutição e a disartria.

Multidisciplinary Evaluation of Pacifier Removal on Oro-Dentofacial Structures: A Controlled Clinical Trial.

It is well recognized that pacifier habit leads to occlusal and orofacial functional changes in children. However, the effects of the interruption of prolonged pacifier habit on the development of the dento-facial complex has not yet been fully characterized. Thus, the aim of this study was to investigate the influence of pacifier removal on aspects of oro-dentofacial morphology and function in preschool children. For that, a pacifier group (n = 28) and a control group (n = 32) of 4-year-old children with and without pacifier habit, respectively, were followed up by a group of dentists and speech therapists at baseline, 6 and 12 months after habit removal. Bite force and lip pressure were assessed using digital systems, and the evaluation of breathing and speech functions was performed using validated protocols, together with the measurements of dental casts and facial anthropometry. The Two-way mixed model ANOVA was used in data analysis. After 12 months, a decrease in malocclusion frequency was observed in pacifier group. Additionally, a change over time was observed in facial, intermolar and palate depth measurements, as well in bite and lip forces and speech function scores, increasing in both groups (p < 0.01). The upper and lower intercanine widths and breathing scores differed between groups at baseline and changed over time reducing the differences. The presence of speech distortions was more frequent in the pacifier group at baseline and decreased over time (p < 0.05). The interruption of pacifier habit improved the maxillary and mandibular intercanine widths, as well as the breathing and speech functions, overcoming the oro-dentofacial changes found. Trial Registration: This clinical trial was registered in the Brazilian Clinical Trials Registry (ReBEC; http://www.ensaiosclinicos.gov.br/), protocol no. RBR-728MJ2.

Relation between oro-facial thermographic findings and myofunctional characteristics in patients with obstructive sleep apnoea.

AIM: To evaluate the thermographic characteristics of oro-facial structures and submental triangle of participants with obstructive sleep apnoea (OSA), as well as to investigate its correlation with the anatomy, posture and functions of the oro-facial structures. METHOD: Eighteen patients diagnosed with OSA by polysomnography (OSA group; 57.4 ± 15.8 years) and 13 healthy participants screened for OSA (control group; 57.8 ± 18.1 years) were included. All participants answered to questionnaires for OSA and excessive daytime sleepiness, and were submitted to infrared image thermography analysis of facial regions of interest (ROIs), oro-facial myofunctional evaluation (OMES-E protocol) and masticatory performance. Statistical analysis included one-way ANOVA and Pearson/Spearman correlation test. RESULTS: Obstructive sleep apnoea group showed lower thermographic measures in many ROIs in the frontal and lateral views of the face, including the submental triangle region, and lower scores of aspect/posture and performance of oro-facial structures, as well lower total score of OMES-E evaluation (P < .05). Scores of aspect/posture and mobility were correlated with the temperature of some ROIs in the frontal and lateral views. CONCLUSION: Lower facial skin and submental triangle region temperatures, measured by infrared thermography, and a worse oro-facial myofunctional condition were identified in the group of individuals with OSA. The higher temperatures of the ROIs were correlated with the better status of aspect/posture and performance of the oro-facial myofunctional structures.

Congenital heart disease in children: Orofacial myofunctional aspects, eating behavior and facial temperature

OBJECTIVE: To characterize the eating behavior, orofacial, speech myofunctional conditions, and facial temperature of children with congenital heart disease. METHOD: This is a cross-sectional and analytical study. The sample consisted of 30 children with heart disease (cyanotic or acyanotic; mean of 5.48 ± 0.84 years old) and 28 healthy children (4.98 ± 0.64 years old). Parents were given a questionnaire to assess eating behaviors (Montreal Children's Hospital Feeding Scale). The orofacial myofunctional assessment protocol (OMES-E), the Child Language Test (ABFW), and thermography infrared of facial temperature were used. Data analysis was conducted by student's t-tests, Chi-square, logistic regression, and correlation analysis. RESULTS: Eating behavior in Parents did not perceive eating behavior differences between the heart disease and control groups. However, the percentage of children with some feeding difficulty was higher in the heart disease group. There was a difference between groups regarding the appearance and posture of structures, the mobility of the mandibular and cheek, swallowing function, and the total function score. Thermographic variables did not differ between the groups, but better performance in orofacial functions correlated with the temperature of the labial commissure and lower lip points. CONCLUSIONS: The frequency of children with eating difficulties was higher among those with congenital heart disease, as was the increased facial temperature at the medial eyelid commission point when submitted to interventional procedures. The orofacial myofunctional aspects showed changes in posture and position, mobility, and orofacial functions among children with heart disease as compared to the control group. There was a correlation between the temperature of the thermo-anatomical points of the labial commissure and the lower lip as well as the OMES-E function score. (AU)

Congenital heart disease in children: Orofacial myofunctional aspects, eating behavior and facial temperature.

OBJECTIVE: To characterize the eating behavior, orofacial, speech myofunctional conditions, and facial temperature of children with congenital heart disease. METHOD: This is a cross-sectional and analytical study. The sample consisted of 30 children with heart disease (cyanotic or acyanotic; mean of 5.48 ± 0.84 years old) and 28 healthy children (4.98 ± 0.64 years old). Parents were given a questionnaire to assess eating behaviors (Montreal Children's Hospital Feeding Scale). The orofacial myofunctional assessment protocol (OMES-E), the Child Language Test (ABFW), and thermography infrared of facial temperature were used. Data analysis was conducted by student's t-tests, Chi-square, logistic regression, and correlation analysis. RESULTS: Eating behavior in Parents did not perceive eating behavior differences between the heart disease and control groups. However, the percentage of children with some feeding difficulty was higher in the heart disease group. There was a difference between groups regarding the appearance and posture of structures, the mobility of the mandibular and cheek, swallowing function, and the total function score. Thermographic variables did not differ between the groups, but better performance in orofacial functions correlated with the temperature of the labial commissure and lower lip points. CONCLUSIONS: The frequency of children with eating difficulties was higher among those with congenital heart disease, as was the increased facial temperature at the medial eyelid commissions point when submitted to interventional procedures. The orofacial myofunctional aspects showed changes in posture and position, mobility, and orofacial functions among children with heart disease as compared to the control group. There was a correlation between the temperature of the thermo-anatomical points of the labial commissure and the lower lip as well as the OMES-E function score.

Masticatory behaviour and chewing difficulties in young adults with temporomandibular disorders.

BACKGROUND: Difficulties and limitations on masticatory function are among the main reasons why patients with temporomandibular disorder (TMD) seek care. OBJECTIVE: To evaluate the masticatory behaviour and perception of chewing difficulties in adults with mild TMD of recent onset, considering the presence of malocclusion. METHODS: Eighty-one young adults were divided into groups according to the presence of TMD and malocclusion: Non-TMD Normal Occlusion (n = 18), Non-TMD Malocclusion (n = 22), TMD Normal Occlusion (n = 18) and TMD Malocclusion (n = 23). TMD was assessed using the TMD Research Diagnostic Criteria and volunteers also answered questionnaires regarding their perception about jaw functional limitation and difficulty to chew foods of different textures. Masticatory and swallowing behaviours were assessed using the Orofacial Myofunctional Evaluation with Scores (OMES) protocol. Chewing time and chewing frequency taken to ingest the test-food were also obtained. Two-way-ANOVA was used to analyse the TMD, occlusion and TMD × occlusion interaction effects. RESULTS: Temporomandibular disorder effect was observed on vertical jaw mobility and jaw function limitation total scores, meaning that groups differed in the perception of opening limitation and mandibular limitation according to TMD status with a medium effect size. Also, more changes in chewing function (OMES-chewing score) and higher chewing frequency was observed in the presence of TMD (P < 0.05). Occlusion effect was only observed on OMES-swallowing score and no TMD × occlusion interaction effect was observed. CONCLUSION: Changes in chewing behaviour, frequency and perception of mandibular limitation was observed in the presence of TMD, pointing out the importance of functional evaluation when planning and establishing a treatment plan.

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.

Does Body Mass Index Interfere in the Formation of Speech Formants?

Abstract 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.

Lack of agreement between objective and subjective measures in the evaluation of masticatory function: A preliminary study.

The evaluation of mastication is important to understand the masticatory behavior and diagnose feeding difficulties. The objective of this preliminary study was to verify if there is agreement between objective and subjective validated methods of chewing evaluation in a convenience sample which consisted of 32 adolescents (mean 15.5years), complete permanent dentition and free of tooth decay. The Quality of Masticatory Function Questionnaire with the Food-Mastication, Habits, Meat, Fruit and Vegetables domains was used in the subjective evaluation. The objective aspects consisted of maximum bite force (BF) and masticatory performance (MP) by mastication of cubes of test-material and sieving to determine the median particle size (X50) and distribution in the sieves ("b"), and by the colorimetric method using colorchangeable chewing gum. Data were submitted to exploratory analysis, normality test and correlation tests (Pearson/Spearman). The correlation between BF and X50 (r=-0.43; p=0.02) and between BF and MP chewing gum (r=0.53; p=0.002) was significant with large effect size. The MP evaluated by chewing gum correlated with X50 (r=-0.34; p=0.055), but not with "b" (r=-0.06; p=0.73), while "b" correlated only with X50 (r=0.52, p=0.002). No significant correlation was observed between the objective measures and the total score of the subjective evaluation; only a negative correlation was observed between "b" and Meat domain (r=-0.40; p=0.023). The objective methods showed moderate correlation with each other and no agreement between the objective and subjective methods was observed in this sample of healthy adolescents, emphasizing the importance of both aspects in the evaluation of masticatory function.

Caracterização da força da língua por meio de medidas objetivas / Characterization of tongue strength via objective measures

RESUMO Objetivo: analisar a força axial da língua e parâmetros relacionados por meio do FORLING. Método: foram analisados os dados de 92 participantes, entre homens e mulheres, com média de 23,3±7,7 anos. Resultados: no parâmetro força média da língua, identificaram-se valores médios de 13,0 N, já para a força máxima observou-se valor médio de 18,3 N. A força média e a máxima da língua apresentaram correlação positiva e associação altamente significante (p<0,001). A energia acumulada pela língua indicou valores de 131,1 N/s. O tempo médio gasto para que se alcance a força máxima da língua foi de 3,8 segundos, indicando um efeito do treinamento ao se comparar a 1ª à 3ª medida, com redução dos valores (p<0,001). Conclusão: o instrumento demonstrou ser capaz de mensurar parâmetros importantes para o fonoaudiólogo, indicando ser uma promissora ferramenta complementar à avaliação clínica fonoaudiológica.

ABSTRACT Purpose: to analyze axial tongue strength and related parameters by using the Forling. Methods: data regarding 92 participants, including men and women with a mean age of 23.3 ± 7.7 years, were analyzed. Results: the mean value of the mean tongue strength was 13.0 N, and the maximum strength value was 18.3 N. The mean and maximum tongue strengths showed positive correlation and highly significant association (p < 0.001). The energy accumulated by the tongue was 131.1 N/s. The mean time required for the maximum tongue strength to be reached was 3.8 s, and the decrease in time (p < 0.001) from the first to the third measurements indicates an effect of training. Conclusion: the instrument proved to be capable of measuring parameters that are important to the speech-language pathologist, indicating that it can be a promising complementary tool for clinical evaluation.

Myofunctional therapy improves adherence to continuous positive airway pressure treatment.

PURPOSE: Few studies have investigated myofunctional therapy in patients with obstructive sleep apnea syndrome (OSAS). The objective of this study was to evaluate the effect of myofunctional therapy on continuous positive airway pressure (CPAP) adherence. METHODS: The study was registered at ClinicalTrials.gov (NCT01289405). Male patients with OSAS were randomly divided into four treatment groups: placebo, patients undergoing placebo myofunctional therapy (N = 24); myofunctional therapy, undergoing myofunctional therapy (N = 27); CPAP, undergoing treatment with CPAP (N = 27); and combined, undergoing CPAP therapy and myofunctional therapy (N = 22). All patients underwent evaluations before and after 3 months of treatment evaluation and after 3 weeks of washout. Evaluations included Epworth sleepiness scale (ESS), polysomnography, and myofunctional evaluation. RESULTS: The 100 men had a mean age of 48.1 ± 11.2 years, body mass index of 27.4 ± 4.9 kg/m2, ESS score of 12.7 ± 3.0, and apnea-hypopnea index (AHI) of 30.9 ± 20.6. All treated groups (myofunctional therapy, CPAP, and combined myofunctional therapy with CPAP) showed decreased ESS and snoring, and the myofunctional therapy group maintained this improvement after the "washout" period. AHI reduction occurred in all treated groups and was more significant in CPAP group. The myofunctional therapy and combined groups showed improvement in tongue and soft palate muscle strength when compared with the placebo group. The association of myofunctional therapy to CPAP (combined group) showed an increased adherence to CPAP compared with the CPAP group. CONCLUSIONS: Our results suggest that in patients with OSAS, myofunctional therapy may be considered as an adjuvant treatment and an intervention strategy to support adherence to CPAP.

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 patient s 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.

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 patient's 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.

Análise da força máxima da mordida segundo a preferência mastigatória / Analysis of maximum bite force according to chewing side preference

Introdução: a preferência mastigatória (PM) é o lado mais usado pelo indivíduo durante o ato de mastigação, que pode estar relacionado com a força máxima da mordida (FMM), que é a máxima força exercida pelo indivíduo durante a fragmentação dos alimentos e é determinada por muitos fatores. Objetivo: analisar a FMM de indivíduos, em diferentes faixas etárias..segundo a PM. Métodos: a amostra constitui em 80 indivíduos, divididos igualmente entre sexo e faixa etária. Cada indivíduo fou submetido a uma avaliação miofuncional, composta por uma avaliação clínica associada à anamnese sobre PM, medidas antropométricas de peso e altura, de onde foi extraído o IMC, avaliação das condições dentárias e avaliação da força máxima de mordida, usando um dinamômetro modelo DDK/M (Kratos, Cotia/SP), na esala N. A avaliação dentária e fa força de mordida foram monitoradas por um profissional da área. Após o computo dos dados, foram submetidos à análise estatística.Resultado: foi observada maior FMM do lado direito em indivíduos que relataram ter PM à direita, e uma tendência para PM à esquerda com maior FMM para o mesmo lado. Conclusão: a PM à direita determina a FMM, o que não acontece com idade, sexo e IMC.

Análise da força de mordida nos diferentes tipos de maloclusões dentárias, segundo Angle / Bite force analysis in different types of angle malocclusions

OBJETIVO: analisar a máxima força de mordida na oclusão normal e maloclusões de Angle; observar a frequência de ocorrência dos tipos de oclusões; analisar a existência de diferença entre as medidas desta força e relacionar a força de mordida com índice de massa corpórea (IMC) de cada indivíduo. MÉTODOS: a amostra foi composta por 100 estudantes do curso de Fonoaudiologia, com faixas etárias entre 17 e 25 anos. Cada indivíduo realizou: 1) Anamnese: composta por dados de identificação pessoal, informações sobre alimentação diária; preferência mastigatória; peso e altura. 2) Classificação da oclusão dentária em: normal ou Classe I, II subdivisão 1ª e 2ª ou Classe III. 3) Avaliação da força de mordida por meio de um dinamômetro digital. Os resultados foram submetidos aos testes estatísticos: Kolmogorov-Smirnov, T-Student Pareado, Teste de Igualdade de Duas Proporções, Teste ANOVA, Comparação Múltipla de Tukey e Teste de Spearman. RESULTADOS: as maiores forças de mordida foram obtidas nos indivíduos com oclusão normal, seguida das maloclusões Classes I, II subdivisão 1ª e 2ª e III, respectivamente; houve maior frequência de ocorrência da maloclusão Classe I, seguida da oclusão normal, maloclusão Classes II subdivisão 1ª e 2ª e III; houve aumento da força média entre a primeira e terceira medida em ambos os lados; não houve correlação entre força de mordida e o índice de massa corpórea (IMC). CONCLUSÃO: o tipo de oclusão influenciou na força de mordida, sendo a maior força obtida após a terceira mensuração e não houve relação entre IMC e força de mordida. .

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 1st division, Class II 2nd 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 1st and 2nd divisions and Class III, respectively; there was higher occurrence of malocclusion Class I, followed by normal occlusion, Class II 1st and 2nd 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. .

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...