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.

Steinert syndrome and repercussions in dental medicine.

Steinert syndrome, also called myotonic dystrophy type 1, is a genetic disorder with autosomal dominant transmission characterized by myotonia and a multisystemic clinical picture that affects several tissues of the human body. The most common systemic phenotypes are: muscular, cardiac, respiratory, CNS, ocular, gynecological, digestive, orthopedical, as well as cognitive and psychological symptoms (cognitive decline). Muscles involved in voluntary movement are highly affected by myotonia especially distal muscles of upper limbs. These patients also show changes in face, chewing and pharynx muscles that can lead to swallowing and speech problems, dysphagia and in most cases to food aspiration and suffocation. Poor oral hygiene resulting from reduced motor mobility and reduced saliva flux can lead to gingival inflammation and periodontal disease. Other oral manifestations include disturbances at the temporomandibular articulation, dental occlusion changes and reduction in teeth number as a result of caries. Main causes of death are pneumonia and cardiac arrhythmias. The etiopathogeny of this syndrome is still not clear, conditioning the existence of a specific treatment for this disease. Nowadays, treatments consist on the release of the existing symptoms, in an attempt to give a better life quality to patients. It is very important to implement actions that can prevent complications and consequently decrease death. Treatments should be applied in an early stage of the disease. Bronchoscopy and artificial respiration should be used to prevent pneumonia, and regular electrocardiographic monitoring should be done to evaluate defects in the conductive system. Several approaches have been applied to rehabilitate swallowing dysfunction and avoid aspiration like videofluoroscopy, postural techniques and adjustment of diet type. It is the aim of this paper to clarify the ethiology, diagnosis, systemic and oral characteristics of the syndrome, as well as to discuss treatments to be applied according to patients affected organs.

Evaluation of oral functions of the stomatognathic system according to the levels of asthma severity.

PURPOSE: To compare the orofacial functions (chewing, swallowing and speech) in children with asthma and healthy children. METHODS: A cross sectional study including 54 children of both genders with ages between 7 and 10 years was conducted. Twenty-seven of these subjects composed the experimental group, and were subdivided into two severity levels of asthma: Group I - mild intermittent and persistent asthma; Group II - persistent moderate to severe asthma. Twenty-seven healthy children were included in the control group (Group III). Speech-language pathology evaluation used the adapted Orofacial Myofunctional Assessment Protocol. Adaptation consisted in the exclusion of the structural part of the test, since this was not the aim of the study. The structural part was excluded because it was not the aim of this study. RESULTS: It was found alterations in oral functions, with significant differences between the three groups. These alterations showed no correlation with asthma severity, since the highest rate of alterations was found in Group I (mild asthma). CONCLUSION: Regardless of the severity level, children with asthma have altered patterns of chewing, swallowing and speech.

Evaluation of oral functions of the stomatognathic system according to the levels of asthma severity / Avaliação das funções orofaciais do sistema estomatognático nos níveis de gravidade de asma

PURPOSE: To compare the orofacial functions (chewing, swallowing and speech) in children with asthma and healthy children. METHODS: A cross sectional study including 54 children of both genders with ages between 7 and 10 years was conducted. Twenty-seven of these subjects composed the experimental group, and were subdivided into two severity levels of asthma: Group I - mild intermittent and persistent asthma; Group II - persistent moderate to severe asthma. Twenty-seven healthy children were included in the control group (Group III). Speech-language pathology evaluation used the adapted Orofacial Myofunctional Assessment Protocol. Adaptation consisted in the exclusion of the structural part of the test, since this was not the aim of the study. The structural part was excluded because it was not the aim of this study. RESULTS: It was found alterations in oral functions, with significant differences between the three groups. These alterations showed no correlation with asthma severity, since the highest rate of alterations was found in Group I (mild asthma). CONCLUSION: Regardless of the severity level, children with asthma have altered patterns of chewing, swallowing and speech.

OBJETIVO: Avaliar as funções orofaciais de mastigação, deglutição e fala em crianças asmáticas e crianças saudáveis. MÉTODOS: Estudo de corte transversal com 54 crianças, com idades entre 7 e 10 anos completos, de ambos os gêneros. Do total, 27 compuseram o grupo experimental e foram subdivididas em dois níveis de gravidade de asma: Grupo I - asma intermitente ou persistente leve; Grupo II - asma persistente moderada ou grave. Fizeram parte do grupo controle (Grupo III) 27 crianças saudáveis. Para a avaliação fonoaudiológica foi utilizado o Protocolo de Avaliação Miofuncional Orofacial adaptado. A adaptação constituiu na exclusão da parte estrutural, já que esta não fazia parte do objetivo do estudo. RESULTADOS: Alterações nas funções orofaciais foram encontradas, com diferenças entre os três grupos estudados. Essas alterações não tiveram relação com a gravidade da asma, visto que o maior índice de alterações foi encontrado no Grupo I (asma leve). CONCLUSÃO: Independentemente do nível de gravidade da doença, crianças asmáticas apresentam padrões alterados de mastigação, deglutição e fala.

O perfil fonoaudiológico do paciente portador de queimaduras de cabeça e pescoço internado no Hospital de Pronto Socorro de Porto Alegre/RS / The speech-language pathology profile of patients with burning of head and neck hospitalized at Emergency Hospital of Porto Alegre/RS

Objetivo: Traçar o perfil fonoaudiológico dos pacientes com queimaduras de cabeça e pescoço internados no Hospital de Pronto Socorro de Porto Alegre. Método: Foram avaliados pacientes com queimaduras entre 2º e 3º grau, acima de 18 anos, internados na Unidade de Terapia Intensiva do Hospital de Pronto Socorro de Porto Alegre e que estivessem próximos da sua alta hospitalar. Foram submetidos à avaliação por meio de um protocolo adaptado, validado nacionalmente, que investigou dados sociodemográficos e perfil fonoaudiológico dos pacientes referidos. Resultados: A amostra foi constituída de 10 pacientes, com etiologia predominante de queimadura por álcool, elétrica e chama, totalizando 6 (60%) casos. Todos os pacientes apresentaram dificuldade de deglutição; 70%, esforço ventilatório; 90%, abertura de boca reduzida. A alteração no tempo máximo de emissão teve maior prevalência no sexo masculino, com média de 10,67 segundos; alterações vocais foram encontradas em 7 (70%) pacientes e 9 (90%) apresentaram alterações articulatórias. A dor esteve presente em 3 (30%) pacientes. Conclusão: O perfil fonoaudiológico foi alterado na amostra investigada, conforme o esperado.

Objective: To describe the speech-language pathology profile of patients with burns of head and neck who were hospitalized at the Emergency Hospital of Porto Alegre. Methods: Assessed patients with burns between 2nd and 3rd degree over 18 years-old at the Intensive-Care Unit of Emergency Hospital of Porto Alegre and they were close to their discharge, underwent an evaluation by a protocol adapted nationally validated that investigated socio-demographic data and speech-language pathology of the referred patients. Results: The sample consisted of 10 patients with predominant etiology of alcohol-burning, electrical and flame, totaling 6 (60%) cases. All patients had difficulty swallowing, 70%, difficulty breathing, mouth opening reduced in 9 (90%) cases, changes in the maximum emission time was most prevalent in males with an average of 10.67 seconds, vocal changes were found in 7 (70%) patients and 9 (90%) showed articulation changes. The pain was present in 3 (30%) patients. Conclusion: As expected, the speech-language pathology profile was changed in the investigated sample.

Respiración bucal: alteraciones dentomaxilofaciales asociadas a trastornos nasorespiratorios yortopédicos / Oral breathing: dentomaxillofacial irregularities associated with nasorespiratory and orthopedic dysfunctions

Fundamento: El hombre nace condicionado para respirar por la nariz y alimentarse por la boca. Al romperse ese mecanismo fisiológico se afecta elcrecimiento y desarrollo, no sólo facial, sino general. Objetivo: Caracterizar las maloclusiones de clase II de Angle de los respiradores bucales entre las edades de 5 a 11 años y su asociación con alteraciones nasorespiratorias y ortopédicas. Método: Se realizó unestudio observacional, descriptivo y correlacional, durante el período de diciembre de 2004 a noviembre de2005. Se realizó el examen clínico a un total de 833 niños, de los cuales se seleccionaron 60 que reunieronlas condiciones para el estudio. Luego se analizó cada caso en las consultas de Ortodoncia, Otorrinolaringología y Ortopedia. Las variables del estudio fueron la edad, el sexo, alteraciones nasorespiratorias, alteraciones ortopédicas y anomalías dentomalixofaciales. Resultados: Las anomalías dentomaxilofaciales másfrecuentes fueron: incompetencia bilabial, vestibuloversión, resalte aumentado, micrognatismo transversal y sobrepase aumentado. Las alteraciones nasorespiratorias que más afectaron los niños fueron la adenoiditis y la hipertrofia de amígdalas. La alteración ortopédica que más predominó fue la cifosis. Conclusiones: Existe una alta relación entre lasanomalías dentomaxilofaciales y las alteraciones nasorespiratorias y ortopédicas, las cuales en generalprovocan grandes daños en los diferentes componentes del aparato estomatognático(AU)

Background: Human beings are conditioned to breathe through the nose and feed through the mouth, when this physiological mechanism is interrupted facial and general growth is also affected. Objective: To characterize Angle´s Class II malocclusions in oralbreathers with nasorespiratory and orthopedic dysfunctions. Method: A correlational, observational and descriptive study was developed from December 2004 to November 2005 including clinical examination of833 children out of which 60 were selected to take part in this study. Each case was analyzed in Orthodontia,Orthopedics and Otolaryngology consultations. The studied variables were: age, sex, nasorespiratory disorders, orthopedic dysfunctions, dental-maxillofacialirregularities. Results: The mot frequent dentalmaxillofacial irregularities were: bilabial incompetence, transversal micrognathism, vestibular version, overjet and overbite. The most important nasorespiratory dysfunctions found in these children were adenoiditis,and tonsil hypertrophy. The most outstanding orthopedic dysfunction was ciphosis. Conclusion: It is conclusiveto state that there is a high relationship between dentomaxillofacial anomalies and nasorespiratory and orthopedic dysfunctions(AU)

Anomalías dentó maxilares y factores asociados en niños con parálisis cerebral / Dento-maxillary analysis and related factors in children with cerebral palsy

Background: Patients with cerebral palsy attending the Children Rehabilitation Institute (Teleton) at Santiago-Chile present open bite and oral disfunctions. Objective: Determine dento-maxillary anomalies related to cerebral palsy and factors associated to feeding, breathing and parafunctional habits. Method: Descriptive study including 80 children of both sex, between 4-12 years-old, with cerebral palsy. A revisión of clinical files, extra and intraoral exams and a parents investigation was performed. Results: 83 percent of children have severe spastic tetraparesis. A high incidence of open bite incisors was found, long faces compatible with dolicofacial growing and labial incompetence. Associated to this facial biotype, mixed breathing with bucal predominance and absence of lateral movements were found in these children. The intermaxillary relation is type I and the Angle's classification is neutrón occlusion. In relation to feeding habits, 50 percent of patiens with tetraparesis eat their food cut in very small pieces, whereas 60 percent with diplegia and hemiparesia eat their food in a normal way. The parafunctional habits were significant (47 percent). Conclusions: Cerebral palsy is an important condition in the development of a dento-maxillary disarmony, like open bite and dysfunctional sthomatognatic system.

Introducción: Los pacientes con parálisis cerebral atendidos en el Instituto de Rehabilitación Infantil de Santiago, presentan mordidas abiertas y disfunción oral. Objetivos: Determinar anomalías dentó maxilares y relacionarlas con diagnóstico de parálisis cerebral y factores asociados de alimentación, respiración y hábitos parafuncionales. Pacientes y Método: Estudio descriptivo transversal, que incluyó revisión de fichas clínicas 2005-2006, examen extra e intraoral y encuesta a los padres de 80 niños, ambos sexos, con diagnóstico de parálisis cerebral entre 4 y 12 años de edad. Resultados: 83 por ciento de los niños, presentó tetraparesia espástica severa. Se encontró alta incidencia de mordida abierta anterior, caras alargadas compatibles con crecimiento dolicofacial e incompetencia labial. Asociado a este biotipo facial, se halló respiración mixta de predominio bucal y ausencia de movimientos de lateralidad. La relación intermaxilar es tipo I y neutro oclusión según clasificación de Angle. De los hábitos de alimentación, el 50 por ciento de los pacientes con tetraparesia comen picado; alrededor del 60 por ciento con diplejia y hemiparesia comen entero. Los hábitos parafuncionales no fueron significativos, 47 por ciento de los pacientes encuestados los tenían. Conclusiones: La parálisis cerebral es una variable importante asociada al desarrollo de una desarmonía dentomaxilar como la mordida abierta y de la disfunción del sistema estomatognático.

Relación de la función masticatoria con los trastornos digestivos / Relation of the masticatory function to the digestive disorders

Se realizó una investigación en la que se relaciona la función masticatoria con los trastornos digestivos en pacientes que acudieron al chequeo médico en el Hospital Militar Docente Dr Joaquín Castillo Duany, en Santiago de Cuba, de enero de 2004 al 2005, mediante un estudio descriptivo y transversal con 199 pacientes de uno y otro sexo y diversos grupos de edades. Se confeccionó un formulario, se agruparon las tablas y se realizó el análisis estadístico. Se observó un predominio de trastornos digestivos en el grupo de 60 años y más, con presencia de desdentamiento y función masticatoria deficiente, por lo que se concluyó que existe una significativa relación entre la función masticatoria y los trastornos digestivos. Se recomienda extender el estudio a todas las áreas de salud, con el fin de utilizar nuestros conocimientos en beneficio de los pacientes(AU)

An investigation was carried out to connect the masticatory function with the digestive disorders in patients that had the medical check-up at Dr Joaquín Castillo Duany Military Teaching Hospital, in Santiago de Cuba, from January 2004 to January 2005, by a descriptive cross-sectional study of 199 patients of both sexes and different ages. A questionnaire was designed, tables were grouped and a statistical analysis was made. It was observed a predominance of digestive disorders in the age group 60 and over, with lack of teeth and deficient masticatory function. It was concluded that there was a significant relation between the masticatory function and the digestive disorders. It was recommended to extend the study to all the health areas so as to use our knowledge for the benefit of the patients(AU)

Lactancia materna su influencia en el desarrollo del aparato estomatognatico en niños / Breast feeding its influence in the Stomatognathic System development in children

Se realiza un estudio descriptivo transversal retrospectivo desde el 1ro de enero hasta julio de 2006 con el objetivo de analizar la influencia de la lactancia materna sobre el aparato estomatognático. El universo está comprendido por cinco grupos de primer grado del Seminternado “Conrado Benítez” conformado por 20 niños cada uno. Se toma como muestra un grupo donde la relación es 1 de 5. Se aplica encuesta para obtener la información deseada. Se tienen en cuenta las siguientes variables: tiempo de lactancia materna, nivel de escolaridad de la madre o tutor, grupos etarios, hábitos bucales incorrectos, alteraciones de la oclusión, en nivel de educación sanitaria las causas que pudieran influir para que una madre amamantara inadecuadamente a su hijo. Se concluye que los hábitos bucales encontrados en los niños examinados estaban relacionados con el tiempo de lactancia materna, donde los que lactaron por más tiempo presentaron menos hábitos bucales incorrectos, las madres con mayor nivel de escolaridad lactaron por más tiempo, el nivel de conocimiento sanitario que predominó en las madres encuestadas fue de regular. Las causas que más influyeron para que las madres lactaran inadecuadamente a sus hijos fueron: poca leche materna y poco apoyo familiar (AU)

Análise da associaçäo entre sucçäo, condiçöes miofuncionais orais e fala / Analysis of the association between sucking, oral myology contitions and speech

Tema: hábitos orais säo considerados fatores etiológicos de distúrbios do sistema estomatogmático. Objetivo: investigou-se a relaçäo do distúrbio de fala com a história de sucçäo e as desordens miofuncionais orais. Método: 50 crianças, média etária 6,5 anos de idade, passaram por avaliaçäo fonoaudiológica e sues pais foram entrevistados. Resultados: de acordo com a análise estatística, o distúrbio de fala foi associado à maior mobiliodade anormal da língua. Conclusäo: a sucçäo prolongada (aleitamento artificial e hábitos) pode modificar o ambiente oral e dificultar a coordennaçäo para a fala.

Estudo clínico sobre a relação da psoríase com alterações da mucosa bucal / Clinical study on relation of the psoriasis with oral mucosa alterations

Foram examinados clinicamente 306 pacientes, sendo 118 psoriásico, 88 portadores de língua geográfica e 100 pacientes com outras doenças. Os pacientes foram submetidos a exame clínico geral, dermatológico e estomatológico completos. Todas as alterações cutâneas e mucosas encontradas foram anotadas. Após o tratamento estatístico dos dados obtidos, constatamos que: a) a prevalência da língua geográfica é maior no grupo psoriásico (13,6%) do que no grupo controle (3%), bem como a língua fissurada (36,4% e 12%, respectivamente); b) existe uma inversão na prevalência da psoríase e língua geográfica com relação a idade; nas faixas etárias mais avançadas, a psoríase; nas faixas etárias mais precoces, a língua geográfica; c) os antecedentes familiares positivos e o estresse emocional apresentam uma frequência aumentada nos pacientes com psoríase e língua geográfica; d) a sintomatologia na psoríase esta representada pelo prurido em 86,4% e pelo ardor em 55%; na língua geográfica, pelo ardor em 53,4%; e) a pesquisa de doenças anteriores, tabagismo e etilismo, mostra uma prevalência aumentada no grupo com psoríase em relação ao grupo com língua geográfica; f) a análise microscópica realizada em 31 biópsias cutâneas psoriásicas revela alterações classicamente descritas, exceto o adelgaçamento das porções suprapapilares da epiderme; g) a prevalência da atopia (34%) é maior no grupo portador de língua geográfica do que nos pacientes do grupo psoriásico (16,1%) e controle (18,0%). Diante destas constatações, pudemos concluir que a língua geográfica pode ser uma forma frusta da psoríase que a precederia com ou sem simultaneidade posterior. O traço clínico comum entre as duas condições são os fatores etiológicos envolvidos, especialmente o estresse emocional e a hereditariedade, bem como a forma de estabelecimento de suas lesões. (AU)