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)

Modelo lineal vs. vectorial: estimación del movimiento mandibular y trabajo mecánico / Linear vs. vector model: estimation of mandible motion and mechanical work

Objetivo: Determinar los momentos de fuerza del haz superficial del masetero (SMH) obtenidos por modelos lineal y vectorial. Métodos: Investigación comparati-va in silico. Se obtuvo la fuerza del SMH con dinamó-metro en 12 pacientes varones adultos jóvenes para calcular el momento de la fuerza y trabajo mecánico a través de simulaciones en JAVA+ con NetBeans8.2. La descomposición de la fuerza fue F.cos α(x,y) y F.cos α(x,y,z) en el modelo lineal y vectorial respectivamen-te. Los momentos de fuerza fueron comparados por ANOVA (p<0,05). Resultados: La fuerza del SMH unila-teral obtenida con dinamómetro (2,5±0,1N) no difirió significativamente del modelo lineal (2,6±0,05N), pero difirió (p<0,001) del vectorial: 1,7, 2,2, 4,2N en x,y,z (general 2,7±0,02N). El momento medio de la fuerza en el modelo vectorial fue -17,9, -15,5, +14,3N.m-2, apuntando a la inclinación mandibular en el eje lateral en dirección caudal anterior, movimiento de inclina-ción en el eje lateral en la dirección cráneo-medial, e inclinación en el eje craneal en la dirección lateral-an-terior. El modelo lineal mostró momento de fuerza de 13,5N.m-2 apuntando un movimiento traslacional en dirección caudal-craneal en el eje anterior-posterior y menor trabajo mecánico del SMH (p=0,012). Con-clusión: Los modelos vectoriales son más eficientes proporcionando datos detallados para estimar los momentos de fuerza y el trabajo mecánico del SMH, y deben incluirse en los algoritmos de cálculo utilizados por dinamómetros (AU)

Objective: to determine the moments of force exerted by the superficial masseter head (SMH) obtained through linear models and vector ones. Methods: comparative in silico research. Data of SMH force obtained with dynamometer in 12 young adult male patients was used to calculate the moment of the force and mechanical work through simulations in JAVA+ performed with NetBeans8.2. Force decomposition was F.cos α(x,y) and F.cos α(x,y,z) in the linear and vector model respectively. The moments of force were compared by ANOVA (p<0.05). Results: Dynamometrical unilateral SMH force (2.5±0.1N) did not differ significantly from the linear model (2.6±0.05N), but differed (p<0.001) from the vector model: 1.7, 2.2, 4.2N on x,y,z (overall 2.7±0.02N). The mean moment of the force in the vector model was -17.9, -15.5, +14.3N.m-2, pointing to mandible's inclination on the lateral axis in anterior-caudal direction, inclination movement on the lateral axis in the cranio-medial direction and inclination on the cranial axis in the lateral-anterior direction. The linear model showed a moment of force of 13.5N.m-2 pointing to translational motion on caudal-cranial direction on the anterior-posterior axis and lower SMH mechanical work (p=0,012). Conclusion: Vector models are more efficient to provide detailed data to estimate the moments of force and mechanical work of SMH and should be included in the calculation algorithms used by dynamometers (AU)

Mastication in children and adolescents with overweight or obesity: a systematic review / Mastigação em crianças e adolescentes com sobrepeso ou obesidade: uma revisão sistemática

ABSTRACT Studies have shown that changes in mastication are related to overweight in children and adolescents as these changes influence the increase in food consumption. The objective of this article was to characterize, through a systematic review, the mastication in children and adolescents with overweight or obesity. For this, two independent authors performed a systematic review of the electronic databases: Medical Literature Analysis and Retrieval System Online, Scopus, Cumulative Index to Nursing and Allied Health, Web of Science and Latin American and Caribbean Literature in Health Sciences. Masticatory characteristics were considered as primary outcomes; the methods of analyzing mastication, the physical characteristics of the foods/materials used in the analyses and the fasting time were considered as secondary outcomes. This review was prepared in accordance with the items of the preferential reports for systematic analysis and meta-analysis. The systematic review protocol was submitted to the International Prospective Registry of Systematic Reviews. Nine articles were included in this review. The reviewed articles suggest that children and/or adolescents with overweight or obese present masticatory damages because they have worse masticatory performance and altered orofacial myofunctional characteristics.

RESUMO Estudos têm demonstrado que alterações na mastigação estão relacionadas ao excesso de peso em crianças e adolescentes, o que pode levar ao aumento do consumo alimentar. O objetivo deste artigo foi caracterizar, através de uma revisão sistemática, a mastigação em crianças e adolescentes com sobrepeso ou obesidade. Para isso, dois autores independentes realizaram uma revisão sistemática nas bases de dados eletrônicas Medical Literature Analysis and Retrieval System Online, Scopus, Cumulative Index to Nursing and Allied Health, Web of Science e Literatura Latino-Americana e do Caribe em Ciências da Saúde. As características mastigatórias foram consideradas desfechos primários; os métodos de análise da mastigação, as características físicas dos alimentos/materiais utilizados nas análises e o tempo de jejum foram classificados como desfechos secundários. Esta revisão foi elaborada de acordo com os itens dos relatórios preferenciais para análise sistemática e metanálises. O protocolo de revisão sistemática foi submetido ao Registro Internacional Prospectivo de Revisões Sistemáticas. Nove artigos foram incluídos nesta revisão. Os resultados dos artigos revisados sugerem que crianças e/ou adolescentes com sobrepeso ou obesidade apresentam danos mastigatórios, pois possuem pior performance mastigatória e características miofuncionais orofaciais alteradas.

Morphological and masticatory performance variation of mouth behavior groups.

Food texture preference and product acceptance are hypothesized to be influenced by mouth behavior. Recent work identified four mouth behavior (MB) groups that describe most consumers in the United States: Chewers, Crunchers, Smooshers, and Suckers. While these behavioral preferences are thought to play a significant role in food selection and purchasing decisions, it is unknown how closely they relate to body and oral cavity measures as well as masticatory apparatus performance. Our objectives were twofold: to determine whether MB groups are related to (a) morphological variation in body, head, and oral cavity size and (b) masticatory apparatus performance (i.e., maximum jaw gape, maximum bite forces at the incisors and first molar). Measurements were collected following an online MB assessment (JBMB Mouth Behavior Typing Tool) where participants self-identified as one of the four types of consumers. As expected, univariate associations were observed between masticatory performance and overall body as well as oral cavity size. These relationships did not persist when assessed with multivariate methods. MB groups did not differ by body, head, or oral cavity measurements; maximum gape; or maximum bite force. Because of small sample sizes for Smooshers and Suckers-a reflection of their limited prevalence in the U.S. population-we interpret the results for these groups with caution. We can more confidently conclude based on our sample that Chewers and Crunchers do not differ in size, bite force, or maximum gape, suggesting other factors primarily drive food texture choice and preference in these individuals.

Muscle-Bone Crosstalk in the Masticatory System: From Biomechanical to Molecular Interactions.

The masticatory system is a complex and highly organized group of structures, including craniofacial bones (maxillae and mandible), muscles, teeth, joints, and neurovascular elements. While the musculoskeletal structures of the head and neck are known to have a different embryonic origin, morphology, biomechanical demands, and biochemical characteristics than the trunk and limbs, their particular molecular basis and cell biology have been much less explored. In the last decade, the concept of muscle-bone crosstalk has emerged, comprising both the loads generated during muscle contraction and a biochemical component through soluble molecules. Bone cells embedded in the mineralized tissue respond to the biomechanical input by releasing molecular factors that impact the homeostasis of the attaching skeletal muscle. In the same way, muscle-derived factors act as soluble signals that modulate the remodeling process of the underlying bones. This concept of muscle-bone crosstalk at a molecular level is particularly interesting in the mandible, due to its tight anatomical relationship with one of the biggest and strongest masticatory muscles, the masseter. However, despite the close physical and physiological interaction of both tissues for proper functioning, this topic has been poorly addressed. Here we present one of the most detailed reviews of the literature to date regarding the biomechanical and biochemical interaction between muscles and bones of the masticatory system, both during development and in physiological or pathological remodeling processes. Evidence related to how masticatory function shapes the craniofacial bones is discussed, and a proposal presented that the masticatory muscles and craniofacial bones serve as secretory tissues. We furthermore discuss our current findings of myokines-release from masseter muscle in physiological conditions, during functional adaptation or pathology, and their putative role as bone-modulators in the craniofacial system. Finally, we address the physiological implications of the crosstalk between muscles and bones in the masticatory system, analyzing pathologies or clinical procedures in which the alteration of one of them affects the homeostasis of the other. Unveiling the mechanisms of muscle-bone crosstalk in the masticatory system opens broad possibilities for understanding and treating temporomandibular disorders, which severely impair the quality of life, with a high cost for diagnosis and management.

Odontología deportiva y prevención de trauma dentoalveolar / Sports dentistry and prevention of dentoalveolar traumas

La odontología deportiva es la rama de la medicina deportiva que se ocupa de la prevención y el tratamiento de las lesiones bucodentales y las enfermedades orales asociadas al deporte y el ejercicio. Por lo que se hace necesario la intervención de profesionales de la salud bucodental para hacer evaluaciones del deportista y el deporte que practica para ver los riesgos que puede tener de desarrollar y sufrir lesiones bucodentales como traumas dentoalveolares y lesiones no cariosas. Y de este modo realizar las recomendaciones a cada paciente que practica deporte, de los elementos que deben usar como equipamiento bucodental para evitar o reducir el daño dentoalveolar (AU)

Sports dentistry is the branch of sports medicine that deals with the prevention and treatment of oral injuries and oral diseases associated with sports and exercise. Therefore it is necessary the intervention of oral health professionals to make evaluations of the athlete and the sport he practices to see the risks that may have to develop and suffer oral injuries such as dentoalveolar trauma and non-carious lesions. And in this way make the recommendations to each patient who practices sports, of the elements that should be used as oral equipment to avoid or reduce dentoalveolar damage (AU)

Differences in the Young modulus and hardness reflect different functions of teeth within the taenioglossan radula of gastropods.

One important autapomorphy of molluscs is the radula, which is the anatomical structure used for feeding in most species of Mollusca. As this phylum represents the second species-richest animal group inhabiting very diverse environments, it is not surprising that the morphology of the radula and its teeth is also very diverse between taxa. However, the taenioglossan radulae are remarkable because its tooth types (central, lateral, and marginal teeth) are highly distinct in their morphology within the same radula. There are several hypotheses attempting to explain this tooth diversity by their functional specialisations. Here, for the first time, the functional morphology of taenioglossan radular teeth from one single species was analysed and their material properties (hardness and elasticity modulus) were characterised by nanoindentation. Spekia zonata Bourguignat, 1879 belongs to the Paludomidae inhabiting and feeding on solid substrates in Lake Tanganyika. All tooth types show gradual and significant differences in their stiffness and hardness: from the basis, as the softest and most flexible area, to the stylus and the cusps as the stiffest and hardest areas. The flexibility of the stylus allows the teeth to act as one single feeding organ: the central and lateral teeth can stabilize each other during feeding by the rear teeth providing support to the next row. Tooth types also differ significantly in their stiffness and hardness: the central teeth consist of the hardest and stiffest material, followed by the lateral teeth and finally marginal teeth. This can be explained by different functional loads of teeth: central and lateral ones are used for scratching over the substrate while the marginals serve mainly as brooms collecting food particles.

General morphology and ultrastructure of the radula of Testudinalia testudinalis (O. F. Müller, 1776) (Patellogastropoda, Gastropoda).

The radular morphology of the patellid species Testudinalia testudinalis (O. F. Müller, 1776) from the White Sea was studied using light, electron, and confocal microscopy. The radula is of the docoglossan type with four teeth per row and consisting of six zones. We characterize teeth formation in T. testidinalis as follows: one tooth is formed by numerous and extremely narrow odontoblasts through apocrine secretion; this initially formed tooth consists of numerous vesicles; the synthetic apparatus of the odontoblasts is localized in the apical and central parts of the cells throughout the cytoplasm and is penetrated by microtubules which are involved in the transport of the synthesized products to the apical part of the odontoblast; the newly formed teeth consist of unpolymerized chitin. Mitotic activity is located in the lateral parts of the formation zone. The first four rows contain an irregular arrangement of teeth, but the radular teeth are regularly arranged after the fifth row. The irregularly arranged teeth early on could be a consequence of the asynchronous formation of teeth and the distance between the odontoblasts and the membranoblasts. The morphological data obtained significantly expands our knowledge of the morphological diversity of the radula formation in Gastropoda.

Influence of Masticatory Behavior on Muscle Compensations During the Oral Phase of Swallowing of Smokers

Abstract Introduction Chewing and swallowing are physiologically interconnected functions, which share motor structures and supranuclear regions of the central nervous system (CNS), involving a sensorimotor synchrony. Objective To analyze the influence of masticatory behavior on muscular compensations in the oral phase of swallowing in smokers compared with nonsmokers. Methods A cross-sectional study comparing smokers and nonsmokers composed of 24 participants in each group. The aspects of food crunching, masticatory pattern, masticatory speed, atypical muscular contractions, and lip closure were analyzed during mastication. In swallowing, aspects of contraction of the orbicular and mental muscles, head movement and presence of deglutition, mastication, smoking, and of stomatognathic system of residues after swallowing were characterized. Results Statistically significant differences were identified between the study groups related to food grinding pattern, masticatory velocity, and mental contraction during swallowing. There was no significant association between masticatory function and compensations during swallowing. Conclusion Differences were observed in the pattern of chewing and swallowing in smokers compared with nonsmokers, but no influence of masticatory performance was observed in the presence of muscle compensations during the oral phase of swallowing.

Effect of implant-supported mandibular overdentures versus reline on masticatory performance and salivary flow rates in very old adults-A randomized clinical trial.

PURPOSE: To compare the masticatory efficiency (ME), maximum voluntary bite force (MBF), masseter muscle thickness (MMT), and salivary flow rates (SFR) in completely edentulous dependent elders treated either with a conversion of their existing mandibular complete removable dental prostheses (CRDPs) into a two-implant overdenture (IOD) or a conventional reline of the CRDP. MATERIAL AND METHODS: Participants were randomly allocated into intervention (IG) and control (CG) groups. The IG received two implants in the mandibular canine regions, and their CRDPs were transformed into IODs. The CG received a conventional reline of their mandibular CRDPs. Outcomes were recorded at each recall visit (baseline, immediately, 3 months, 12 months after intervention, and subsequently on an annual basis). Statistical analyses used mixed linear regression models (level of significance: p < 0.05). RESULTS: The IG comprised 16 participants (age = 85.0 ± 6.2 years), while the CG comprised 16 (age = 84.8 ± 5.4 years), with a mean follow-up of 2.7 ± 2.2 years (range: 3 months-7 years). A significant increase of MBF in the IG was observed with an overall gain of 80 N (p < 0.001) compared with the reline group. There were no significant long-term changes in SFR, MMT, or ME within/between groups. CONCLUSION: Since dependent elders with mandibular IODs present a significant gain in MBF, but no relative increase in SFR, MMT, and ME, it seems that this increased capacity of MBF is not exploited by the elders during their habitual chewing.

Effects of electrostimulation associated with masticatory training in individuals with down syndrome. / Efeitos da eletroestimulação associada ao treino mastigatório em pessoas com síndrome de down.

Purpose Investigate and measure the effects of electrostimulation on the orofacial musculature and on the chewing, breathing and swallowing functions of individuals with Down syndrome. Methods Study participants were 16 individuals with Down syndrome (six males and 10 females) from an institutional extension project aged nine to 25 years. Speech-language pathology assessment was performed using the protocol of Orofacial Myofunctional Evaluation with Scores (OMES) pre- and post-intervention. This protocol comprised eight weekly electrostimulation sessions. Functional Electrical Stimulation (FES) current was used at a frequency of 10Hz in warm-up and 30Hz in application, intermittent stimulation (cycling pulses) with ON-time of 5s and OFF-time of 10s common to both stages, and pulse width of 200µs in warm-up and 250µs in application. Results Significant differences were observed between pre- and post-application of FES regarding cheek appearance (flaccidity and arching), tongue mobility (right and left laterality), and musculature behavior during performance of functions of the stomatognathic system: respiration, deglutition (lip behavior), and mastication (bite and trituration). Conclusion Effects of electrostimulation associated with masticatory training of the masseter muscles were statistically identified, with functional gains in chewing, breathing and swallowing performance in individuals with Down syndrome.

Functional Assessment of the Stomatognathic System, after the Treatment of Edentulous Patients, with Different Methods of Establishing the Centric Relation.

The study compares subjective experiences of patients, wearing complete dentures. Two different methods of determining a centric relation were performed: the traditional method using wax occlusal rims and the Gerber method, based on gothic arch tracings. The success rate of establishing a centric relation in both methods was evaluated (rentgenodiagnostics). The influence of the method used to obtain the centric relation on patients' stomatognathic system (condyle centralization, pain) was also evaluated. Better results were achieved in gothic arch tracing method. Before every prosthetic treatment of edentulous patients, a functional analysis of the TMJ is necessary. The lack of centric relation, in a long term adaptation patients, does not lead to TMD symptoms. This trial is registered with NCT03343015.

Adaptation to new complete dentures-is the neuromuscular system outcome-oriented or effort-oriented?

OBJECTIVE: The aim of this study was to observe the adaptation strategy of the stomatognathic system during the adaptation of complete dentures, comprising masticatory parameters and subjective measures. Our hypothesis was that with new dentures, masticatory performance would increase while the effort of the system is kept constant. MATERIAL AND METHODS: Thirty-two patients received standardized new complete dentures. Masticatory performance tests were conducted with old dentures (T1), immediately after incorporation of new dentures (T2) and after an adaptation period of 3 months (T3). Patients habitually chewed the silicone-based artificial test food Optocal. The comminuted test food was analyzed and mean particle sizes (x50) were calculated. Simultaneously, surface EMGs of the anterior temporalis and masseter muscles were recorded. Specific (SMW) and total muscle work (TMW) were determined. Patients filled in the OHIP-49 questionnaire. Test conditions were compared using repeated-measures ANOVA with SPSS 22 (SPSS Inc.) RESULTS: Masticatory performance increased (P = 0.016) between old (x50 = 4.99 ± 0.28) and adapted new dentures (x50 = 4.80 ± 0.33). TMW deteriorated (P = 0.004) at T2 (from TMW1 = 119.77 ± 56.49 to TMW2 = 92.12 46.27), and increased again (P = 0.028) at T3 (TMW3 = 107.66 ± 44.65). OHIP scores decreased significantly in all subscales (P < 0.001…P = 0.046); the total score was reduced (P < 0.001) from 56.24 ± 29.05 (T1) to 34.66 ± 24.74 (T3). CONCLUSION: In complete denture wearers, masticatory performance improves over an adaptation period. Muscle work initially decreased before reaching its original level again after adaptation. Subjective parameters overestimated the functional improvements. CLINICAL SIGNIFICANCE: The subjective evaluation does not adequately reflect functional improvements. The assessment of function requires an adaptation period.

Alterations in the Masticatory System in Patients with Amyotrophic Lateral Sclerosis.

AIMS: To determine the effect of amyotrophic lateral sclerosis (ALS) on aspects of masticatory function and to assess the relationship between ALS and the prevalence of traumatic mucosal lesions caused by oral self-injury. METHODS: A total of 153 ALS patients and 23 control subjects participated in this cross-sectional study. Clinical characteristics including site of onset, medication, type of feeding, and use of noninvasive mechanical ventilation were recorded. The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocol and a specific questionnaire to assess aspects of masticatory dysfunction and frequency of self-injury of the oral mucosa were applied to all participants. Maximum mandibular range of motion, maximum bite force, and maximum finger-thumb grip force were determined and tested with Mann Whitney, Kruskal-Wallis, or chi-square tests. P < .05 was considered significant. RESULTS: Maximum unassisted and assisted mouth opening, protrusion, left laterotrusion, and finger-thumb grip force were significantly reduced in both spinal- (n = 102) and bulbar-onset (n = 40) patients compared to the control group; however, bite force was reduced only in bulbar-onset patients. ALS patients with tube feeding (n = 16) had the greatest reduction in maximum bite force and mandibular opening. There was no relationship between TMD and ALS. Oral self-injury due to biting was more frequent in the ALS group (29.9%) than in the control group (8.7%) and in the bulbar-onset group (55.0%) compared to the spinal- (20.8%) and respiratory-onset (18.2%) groups. Of the ALS patients in the study, 10% sought dental treatment related to the condition. CONCLUSION: The ALS patients in this study had a reduction in finger-thumb grip force that was twice as great as the reduction in bite force. The maximum range of mandibular movement was also reduced, especially in bulbar-onset patients. ALS patients did not have a higher prevalence of TMD but did have more traumatic mucosal injury than controls. The dentist should be an integral part of the multidisciplinary team to manage ALS patients.

Efeitos da eletroestimulação associada ao treino mastigatório em pessoas com síndrome de down / Effects of electrostimulation associated with masticatory training in individuals with down syndrome

RESUMO Objetivo Investigar e mensurar os efeitos da eletroestimulação na musculatura orofacial e nas funções de mastigação, respiração e deglutição dos indivíduos com síndrome de Down. Método Participaram da pesquisa 16 indivíduos com Síndrome de Down, sendo seis do gênero masculino e dez do gênero feminino com idade entre 9 e 25 anos, participantes de um projeto de extensão institucional. Foram realizadas avaliações fonoaudiológicas com uso do protocolo AMIOFE antes e após a intervenção, que consistiu em oito sessões de eletroestimulação semanais. A corrente utilizada foi a Functional Electrical Estimulation (FES), com uma frequência de 10Hz no aquecimento e 30 Hz na aplicação, em um tempo ON de 5s e OFF de 10s comuns nas duas etapas, e com a largura de pulso de 200(µs) no aquecimento e 250(µs) na aplicação. Resultados Observaram-se diferenças significativas após aplicação da eletroestimulação (FES) em relação ao aspecto das bochechas quando comparadas flacidez/arqueamento pré e pós o estímulo elétrico, diferenças na mobilidade de língua (lateralidade direita e esquerda), no comportamento da musculatura na execução das funções estomatognáticas de respiração, melhoria no comportamento dos lábios durante a deglutição e mudanças expressivas no processo de mastigação (mordida e trituração). Conclusão Foi identificado estatisticamente que houve efeito após a eletroestimulação associada ao treino mastigatório nos músculos masseteres, com ganhos funcionais na execução da mastigação, respiração e deglutição, em pessoas com Síndrome de Down.

ABSTRACT Purpose Investigate and measure the effects of electrostimulation on the orofacial musculature and on the chewing, breathing and swallowing functions of individuals with Down syndrome. Methods Study participants were 16 individuals with Down syndrome (six males and 10 females) from an institutional extension project aged nine to 25 years. Speech-language pathology assessment was performed using the protocol of Orofacial Myofunctional Evaluation with Scores (OMES) pre- and post-intervention. This protocol comprised eight weekly electrostimulation sessions. Functional Electrical Stimulation (FES) current was used at a frequency of 10Hz in warm-up and 30Hz in application, intermittent stimulation (cycling pulses) with ON-time of 5s and OFF-time of 10s common to both stages, and pulse width of 200μs in warm-up and 250μs in application. Results Significant differences were observed between pre- and post-application of FES regarding cheek appearance (flaccidity and arching), tongue mobility (right and left laterality), and musculature behavior during performance of functions of the stomatognathic system: respiration, deglutition (lip behavior), and mastication (bite and trituration). Conclusion Effects of electrostimulation associated with masticatory training of the masseter muscles were statistically identified, with functional gains in chewing, breathing and swallowing performance in individuals with Down syndrome.

Posture and posturology, anatomical and physiological profiles: overview and current state of art.

BACKGROUND AND AIM OF WORK: posture is the position of the body in the space, and is controlled by a set of anatomical structures. The maintenance and the control of posture are a set of interactions between muscle-skeletal, visual, vestibular, and skin system. Lately there are numerous studies that correlate the muscle-skeletal and the maintenance of posture. In particular, the correction of defects and obstruction of temporomandibular disorders, seem to have an impact on posture. The aim of this work is to collect information in literature on posture and the influence of the stomatognathic system on postural system. METHODS: Comparison of the literature on posture and posturology by consulting books and scientific sites. RESULTS: the results obtained from the comparison of the literature show a discrepancy between the thesis. Some studies support the correlation between stomatognathic system and posture, while others deny such a correlation. CONCLUSIONS: further studies are necessary to be able to confirm one or the other argument.

Influencia del tipo de masticación sobre la memoria y el aprendizaje espacial en ratones albinos de la cepa BALB/c / Influence of chewing behaviour on memory and spatial learning in albino BALB/c mice

Introducción. Debido a que la relación entre la masticación y las funciones cognitivas no está todavía completamente elucidada, se tuvo como objetivo determinar la influencia del tipo de masticación sobre la memoria y el aprendizaje espacial en ratones albinos machos de la cepa BALB/c. Métodos. Veinte ratones de 8 semanas de edad fueron divididos en 2 grupos iguales; el grupo masticación normal fue mantenido con alimentación en granos, la misma que recibieron los 20 ratones desde el destete; el grupo masticación deficiente se alimentó con granos pulverizados. Se evaluó a los ratones a las 16 semanas de edad durante 5 días, los primeros 4 días en la fase de adquisición y el quinto día en la fase de recuperación de memoria y aprendizaje espacial en el laberinto acuático de Morris. Resultados. Tanto en la fase de adquisición como de recuperación, no se hallaron diferencias significativas en los grupos masticación normal vs. masticación deficiente. Sin embargo, las diferencias sí fueron significativas en la fase de adquisición del grupo masticación normal, comparando los resultados del primer día vs. los otros 3 días. Conclusiones. Estos resultados indican que la masticación normal influye sobre la memoria y el aprendizaje espacial, al disminuir los tiempos de latencia en encontrar la plataforma oculta en la fase de adquisición dentro de dicho grupo experimental (AU)

Introduction. Since the relationship between chewing and cognitive functions has not been fully elucidated, this study aimed to determine the impact of chewing behaviour on spatial learning and memory in albino male BALB/c mice. Methods. Twenty mice aged 8 weeks were divided into 2 equal groups. The regular chewing group was fed with uncrushed grains (the same diet given to all 20 mice since they were weaned) and the limited chewing group was fed with crushed grains. At 16 weeks of age, the mice were evaluated over 5 days, including a 4-day acquisition phase prior to a probe test of spatial learning and memory in the Morris water maze on the fifth day. Results. A comparison of the regular chewing group and the limited chewing group found no significant differences in either the acquisition phase or the probe test. However, there were significant differences in the acquisition phase for just the regular chewing group when comparing results from the first day to those from the other 3 days. Conclusions. The results suggest that regular chewing affects spatial learning and memory since mice in the regular chewing group decreased their times to find the hidden platform during the acquisition phase (AU)

Study of the kinematic variables of unilateral and habitual mastication of healthy individuals. / Estudo das variáveis cinemáticas da mastigação unilateral e habitual de indivíduos saudáveis.

PURPOSE: To describe and compare the temporal-spatial kinematic variables of mandibular movement during deliberate unilateral and habitual mastication in healthy young-adult individuals. METHODS: The study sample was composed of eight male healthy volunteers aged 19 to 24 years. The kinematic data were obtained using a motion analysis system - Qualisys Track Manager (QTM) ProReflex MCU. Recordings were performed during deliberate unilateral mastication (UM) and habitual mastication (HM) of firm-consistency gummy candy. The following variables were analyzed: (1) masticatory sequence: duration, number of masticatory cycles, and chewing rate; (2) masticatory cycle: duration, vertical and medial-lateral mandibular range of motion in relation to the skull, and maximum velocity during the opening and closing phases. Data of the variables were compared during UM and HM by the paired t test, and the effect sizes ('d' Cohen) were calculated. RESULTS: Regarding the variables of the masticatory sequence, smaller chewing rate was observed for UM compared with that for HM (1.19±0.21Hz and 1.29±0.16Hz, respectively, p=0.004, d=0.53). Smaller values of maximum velocity during the opening (MU=67.4 mm/s and MH=80.02, p=0.053, d=0.80) and closing (MU=71.77±9.35mm/s and MH=3.51±7mm/s, p=0.014, d=0.79) phases of the masticatory cycle were observed in deliberate unilateral mastication compared with those in habitual mastication. CONCLUSION: Kinematic variables associated with the sequence and cycle of mastication are influenced by the chewing pattern adopted - deliberate unilateral or habitual.

Bases neurocientíficas de la función masticatoria y su efecto sobre el estrés y las funciones cognitivas / Neuroscientific basis of the masticatory function and its effects on stress and cognitive functions

The subtle neuroscientific mechanisms related to chewing evinces its functionality as astimulator of different areas in the neocortex. This paper is a thorough review of the neuroscientific evidence related to the functionality of chewing and its impact on other and more complex processes, with the aim of presenting chewing as a physiological mechanism to counteract stress and ease important cognitive functions. Thus, becoming more visible as a marginal activity to pay attention, especially, within people prone to develop a decline on learning and memory functions.

Los mecanismos neurocientíficos subyacentes a la masticación permiten explicar cómo dicha función puede llegar a estimular diversas áreas del neocórtex. Esta revisión busca actualizar y compendiar la evidencia sobre las bases neurocientíficas de la función masticatoria para así entender su implicancia en algunos procesos superiores, concluyendo, al final del artículo, que la masticación actuaría como un mecanismo fisiológico modulador tanto en el estrés como en importantes funciones cognitivas; emergiendo como una actividad periférica a ser tomada en cuenta, sobre todo, en las poblaciones vulnerables de sufrir deterioro en la función mnésica y en la función de aprendizaje.