Influence of oral health condition on swallowing and oral intake level for patients affected by chronic stroke

Cláudia T Mituuti,1 Vinicius C Bianco,2 Cláudia G Bentim,3 Eduardo C de Andrade,1 José H Rubo,2 Giédre Berretin-Felix1 1Speech Language and Hearing Department, 2Department of Prosthodontics, Bauru School of Dentistry/University of São Paulo, Bauru, Brazil; 3SORRI-BAURU, Bauru, Brazil Background: According to the literature, the occurrence of dysphagia is high in cases of stroke, and its severity can be enhanced by loss of teeth and the use of poorly fitting prostheses.Objective: To verify that the status of oral health influences the level of oral intake and the degree of swallowing dysfunction in elderly patients with stroke in chronic phase.Methods: Thirty elderly individuals affected by stroke in chronic phase participated. All subjects underwent assessment of their oral condition, with classification from the Functional Oral Intake Scale (FOIS) and nasoendoscopic swallowing assessment to classify the degree of dysphagia. The statistical analysis examined a heterogeneous group (HG, n=30) and two groups designated by the affected body part, right (RHG, n=8) and left (LHG, n=11), excluding totally dentate or edentulous individuals without rehabilitation with more than one episode of stroke.Results: There was a negative correlation between the need for replacement prostheses and the FOIS scale for the HG (P=0.02) and RHG (P=0.01). Differences in FOIS between types of prostheses of the upper dental arch in the LHG (P=0.01) and lower dental arch in the RHG (P=0.04). A negative correlation was found between the number of teeth present and the degree of dysfunction in swallowing liquid in the LHG (P=0.05). There were differences in the performance in swallowing solids between individuals without prosthesis and those with partial prosthesis in the inferior dental arch (P=0.04) for the HG.Conclusion: The need for replacement prostheses, type of prostheses, and the number of teeth of elderly patients poststroke in chronic phase showed an association with the level of oral intake and the degree of oropharyngeal dysphagia. Keywords: deglutition, mouth rehabilitation, aged, prosthodontics, dysphagia, cerebrovascular disorder

Influence of Orthognathic Surgery on Voice Fundamental Frequency

Considering that orthognathic surgery promotes changes in orofacial structures constituting the resonating system, functional changes secondary to surgery are expected to affect speech, leading to the need for further speech and voice adjustments. Thus, understanding the possible relationships of these structures with voice production is important. Therefore, this Study aimed to describe the changes in voice fundamental frequency of a patient submitted to orthognathic surgery and observe if there is a relationship with hyoid bone positioning at the different treatment periods. The results revealed that voice fundamental frequency increased after surgery, returning to values close to the preoperative condition, which corresponded to vertical movement of the hyoid bone

Estudo eletromiográfico do músculo masseter durante o apertamento dentário e mastigação habitual em adultos com oclusão dentária normal Electromyographic study of the masseter muscle during maximal voluntary clenching and habitual chewing in adults with normal occlusion

OBJETIVO: Analisar a diferença entre os lados na atividade eletromiográfica do masseter em indivíduos adultos com oclusão dentária normal. MÉTODOS: Foram avaliados 30 indivíduos saudáveis entre 21 e 30 anos e realizou-se eletromiografia de superfície nos músculos masseteres direito e esquerdo, durante apertamento em máxima intercuspidação e mastigação habitual com uva passa. Foram computados os valores médios dos três apertamentos dentários e dos 15 segundos da mastigação habitual para cada indivíduo. Foram considerados para a análise: o lado de maior valor e o de menor valor eletromiográfico. RESULTADOS: Durante o apertamento dentário, a diferença média entre os dois lados foi de 20,0 microvolts (&#956;V) com intervalo de confiança (95%) entre 14,0 e 26,0 &#956;V e durante a mastigação habitual, a diferença média entre os dois lados foi de 10,3 &#956;V com intervalo de confiança (95%) entre 6,7 e 13,8 &#956;V. CONCLUSÃO: Houve diferença estatisticamente significante entre os lados, com relação entre eles de 24% para o apertamento dentário e de 27% para a mastigação habitual, em indiv duos adultos saudáveis.<br>PURPOSE: To analyze the difference between both sides of the face during the electromyographic activity of the masseter muscle in adults with normal occlusion. METHODS: Thirty healthy individuals with ages ranging from 21 to 30 years old were selected. Surface electromyography was performed on right and left masseter muscles during maximal voluntary clenching and habitual chewing with raisins. The mean values of three teeth clenching and fifteen seconds of habitual chewing were calculated for each subject. The analysis considered the sides with higher and lower electromyographic activity. RESULTS: During maximal voluntary clenching, the mean difference between sides was 20.0 microvolts (&#956;V), with confidence interval (95%) between 14.0 and 26.0 &#956;V. During habitual chewing, the mean difference between sides was 10.3 &#956;V, with confidence interval (95%) between 6.7 and 13.8 &#956;V. CONCLUSION: There was a statistically significant difference between both sides of the face in healthy adult subjects, with a relation between sides of 24% for maximal voluntary clenching and 27% during habitual chewing