PRÁCTICA BASADA EN EVIDENCIAS: Futuro de la Motricidad Orofacial

DOCUMENTO DE LA CONFERENCIA DE IRENE MARCHESA

Effect of lingual frenotomy on tongue and lip rest position: a nonrandomized clinical trial

Introduction: The tongue plays an important role in the development of craniofacial structures. At rest, the light and constant pressure of the tongue against the hard palate, counterbalanced by the pressure provided by proper lip sealing, serves as a guide for maxillary growth. Ankyloglossia makes tongue coupling against the hard palate difficult, impacting maxillary development, which may lead to breathing disorders. Objective: To verify the effect of lingual frenotomy on the resting position of the tongue and lips in infants with ankyloglossia. Methods: The sample consisted of 334infants aged between 1 and 60 days old diagnosed with ankyloglossia. The groups were divided in: a) experimental group (EG), which consisted of infants whose mothers agreed with lingual frenotomy; b) control group (CG), which consisted of infants whose mothers either refused lingual frenotomy or were waiting for surgery. Both the position of the lips and of the tongue at rest were assessed while the infants were sleeping during the quiet sleep phase. Formothers who refused their infants to undergo the surgical procedure, a follow-up of the infants was proposed to verify possible interference of the frenulum with the resting position of the tongue and lips. Infants whose mothers agreed with surgery were referred for lingual frenotomy. Results: Regarding the position of the tongue and lips at rest at the initial and final assessments, the statistical analysis demonstrated significant differences between both groups. Conclusion: Lingual frenotomy enabled infants diagnosed with ankyloglossia to maintain both tongue coupling against the hard palate and closed lips at rest.info:eu-repo/semantics/publishedVersio

Is there a relation between harmful oral habits and facial typology and dental occlusion?

OBJETIVO: verificar se há predominância de hábitos orais deletérios nos diferentes tipos faciais eaprofundar o estudo da relação entre os hábitos orais deletérios e a oclusão dentária. MÉTODO: foram analisados 307 prontuários de pacientes entre 2 e 59 anos de idade de ambos os sexos, encaminhados ao ambulatório do Instituto CEFAC. Foram anotados dos prontuários os hábitos orais deletérios, oclusão dentária, tipologia facial, sexo e idade. RESULTADOS: observou-se que os hábitos com maior prevalência são: chupeta (125 indivíduos), ranger dentes (115 indivíduos) e mamadeira (102 indivíduos). Dentre as comparações estudadas, as que apresentaram diferença estatisticamente significante foram: a presença do uso da chupeta no grupo de 9 a 12 anos, quando comparado ao de 6 a 9 anos (p=0,0269); presença do hábito de ranger dentes no grupo de 3 a 6 anos quando comparado ao grupo com mais de 20 anos (p=0,0393); presença do hábito de ranger dentes no grupo de oclusão dentária classe I quando comparado ao classe III (p=0,0128) e presença de oclusão dentária classe I no sexo feminino quando comparado ao masculino (p=0,0177). CONCLUSÃO: não há relação entre os hábitos orais deletérios e a tipologia facial. Entretanto, há relação entre o hábito oral deletério de ranger dentes com a oclusão dentária Classe I de Angle.PURPOSE: to check whether there is a predominance of deleterious oral habits in different facial typesand further study of the relationship between harmful oral habits and dental occlusion. METHOD: we analyzed 307 cases of patients between 2 and 59-year old of both genders, referred to the outpatient clinic of CEFAC Institute. Were we registered medical records of deleterious oral habits, dental occlusion, facial type, gender and age. RESULTS: we observed that the following habits are most prevalent: pacifier (125 subjects), gnashing teeth (115 subjects) and bottle (102 individuals). Among the comparisons, the ones who showed statistical significance was the presence of pacifier use in the group from 9 to 12 years, compared to 6 to 9 years (p=0.0269), presence of habit of gnashing teeth in the group from 3 to 6 years when compared to more than 20 years (p = 0.0393), presence of the habit of gnashing teeth in the group of dental occlusion class I compared to class III (p = 0.0128) and presence dental occlusion class I in females compared to males (p=0.0177). CONCLUSION: there is no relationship between harmful oral habits and facial typology. However, there is a relationship between the harmful oral habit of grinding the teeth with Angle class I dental occlusion

Orofacial myofunctional evaluation: MBGR protocol

OBJETIVO: apresentar um protocolo com escores na área de motricidade orofacial intitulado Protocolo MBGR. MÉTODOS: a partir de protocolos utilizados na área da motricidade orofacial foi elaborado um novo protocolo contendo escores, o qual foi aplicado em sujeitos normais e em pacientes, em cinco fases distintas durante dois anos. A aplicação do protocolo, em cada fase, foi realizada por juízes independentes. Sempre ao final de cada fase o grupo que elaborou o protocolo fez os ajustes necessários para que o mesmo pudesse ser sensível aos problemas da área da motricidade orofacial. RESULTADOS: um novo protocolo na área de motricidade orofacial com escores foi elaborado e testado durante dois anos em cinco diferentes fases possibilitando obter parâmetros numéricos. CONCLUSÃO: foi apresentado o Protocolo MBGR com escores, o qual permite ao fonoaudiólogo avaliar, diagnosticar e estabelecer prognóstico em motricidade orofacial.PURPOSE: to present a protocol with scores on the Orofacial Myofunctional area. This protocol is called MBGR. METHODS: based on different protocols used in the Orofacial Myofunctional area, a new protocol with scores was elaborated. This protocol was applied in both, patients and non-patients during five distinct phases during the elaboration. After each phase, the results were analysed and the necessary corrections were performed in order to improve the protocol and, in this way, provide an accurate diagnosis and prognosis. It took two years to elaborate the protocol. During those two years, independent judges were responsible for testing the protocol in each phase. RESULTS: a new protocol with scores on the Orofacial Myofunctional area was elaborated and tested during two years in different phases. The new MBGR Protocol gives the possibility to obtain numeric parameters. CONCLUSION: the MBGR Protocol with scores was presented. This protocol helps the Speech-Language Pathologist to evaluate and give the diagnosis and the prognosis on the Orofacial Myology area

Lingual frenulum alteration and chewing interference

OBJETIVO: verificar se indivíduos com alteração do frênulo da língua apresentam alteração na mobilidade da língua e na mastigação. MÉTODOS: a casuística desta pesquisa foi composta por dois grupos, um alvo e outro controle, cada um deles com 10 indivíduos. O grupo alvo apresentava alteração de frênulo da língua. Todos foram submetidos aos protocolos de avaliação de frênulo da língua e de mastigação. As provas de mobilidade da língua e de mastigação foram filmadas. Todos os frênulos da língua foram fotografados. RESULTADOS: os dados coletados mostraram que os indivíduos com alteração do frênulo têm 5,447 vezes mais chance de apresentar alteração na mobilidade da língua que indivíduos com frênulo normal. Os indivíduos com alterações da mobilidade da língua não mantiveram constância quanto ao tempo mastigatório. Quanto à mastigação no Modo de Trituração, 100% dos indivíduos do grupo controle utilizaram os dentes posteriores. Entre os indivíduos com alteração do frênulo da língua, 47% mastigaram usando os dentes posteriores e 53% utilizaram os dentes anteriores e/ou fizeram amassamento com a língua. Com relação as atipias musculares, os indivíduos com alteração de frênulo possuíram 5,714 vezes mais chance de apresentá-las durante a mastigação que os indivíduos do grupo controle. CONCLUSÃO: indivíduos com alterações do frênulo da língua apresentaram alterações dos movimentos da língua e alterações na mastigação.PURPOSE: to check if individuals with lingual frenulum alteration demonstrate chewing interference. METHODS: the casuistry of this research was carried out with two groups, a target and a control group, each one with ten individuals. The target group had lingual frenulum alteration. All subjects were submitted to lingual frenulum and chewing evaluation protocols. This procedure was recorded. RESULTS: the collected samples showed that individuals with lingual frenulum alteration have 5.447 times more chances of show tongue mobility alteration than individuals with normal frenulum. Subjects with tongue mobility alteration haven't kept regularity when it comes to mastication period. As for the chewing, on the grinding mode, 100% of the control group used the back teeth. Among the subjects with frenulum alteration, 47% used the back teeth and 53% chewed with the front teeth and/or mashing with the tongue. Regarding muscle atypical movements, individuals with frenulum alteration have 5.714 times more chances to show them during the chewing than individuals from the control group. CONCLUSION: individuals with lingual frenulum alteration showed tongue mobility alteration and mastication alterations

Posture, lips and tongue tone and mobility of mouth breathing children

PURPOSE: to characterize lips and tongue posture, tone and mobility of mouth breathing children. METHOD: the subjects of this study, conducted in São Paulo, SP, Brazil, were 40 mouth breathing children, 26 (65%) male and 14 (35%) female, aging between 7 and 10-year old. MBGR protocol was used to evaluate the aforementioned aspects. RESULTS: the following results were obtained for lip posture: semi-open lips (32.5%), alternating between open and closed lips (27.5%), open lip posture (22.5%) and closed lips (17.5%). With regards to the upper lip tone: 90% showed normal muscle tone, 10% lower tone, and no subjects showed a higher muscle tone. As for the tone of the lower lip, 80.0% of the children showed lower muscle tone, and 20.0% normal muscle tone. For the lips mobility variable, 100% had their mobility close to the best scores. Regarding tongue posture, 57.5% had a low-lying resting tongue posture, 32.5% did not allow for observation of this variable, and in 10.0% of the subjects the tongue was placed in an interdental resting posture. As for tongue muscle tone, 52.5% showed lowered tone, and 47.5% were considered normal. When assessing tongue mobility, 100% had mobility close to the best scores. CONCLUSION: characteristics of posture, tone and mobility of lips in this study's mouth breathing children were: semi-opened lip posture, upper lip with normal tone, lower lip with lowered tonicity and normal mobility. Regarding tongue characteristics: low-lying resting posture, lowered muscle tone and normal mobility.OBJETIVO: caracterizar a postura, o tônus e a mobilidade dos lábios e da língua de crianças respiradoras orais. MÉTODO: participaram do estudo realizado em São Paulo, SP, Brasil, 40 crianças respiradoras orais, sendo 26 (65%) do sexo masculino e 14 (35%) do sexo feminino, com idades entre 7 e 10 anos. Utilizou-se o protocolo MBGR para avaliação dos aspectos analisados. RESULTADOS: foram encontrados os seguintes achados para postura dos lábios: entreabertos (32,5%), alternância entre abertos e fechados (27,5%), abertos (22,5%) e fechados (17,5%). Em relação ao tônus do lábio superior: 90% apresentaram tônus normal, 10% diminuído e nenhuma com tônus aumentado. Quanto ao tônus de lábio inferior, 80,0% das crianças apresentaram tônus diminuído e 20,0% normal. No item mobilidade dos lábios, 100,0% apresentaram mobilidade mais próxima dos melhores escores. Em relação à postura habitual da língua, em 57,5% esta estrutura permaneceu no assoalho, em 32,5% não foi possível observar sua posição e em 10,0% se encontrava em posição interdental. Quanto ao tônus da língua, 52,5% apresentaram tônus diminuído e 47,5% normal. Na avaliação de mobilidade de língua, 100,0% apresentaram mobilidade mais próxima dos melhores escores. CONCLUSÃO: as características de postura, tônus e mobilidade dos lábios das crianças respiradoras orais estudadas foram: lábios entreabertos, lábio superior com tônus normal, lábio inferior com tônus diminuído e mobilidade normal. Em relação à língua: postura no assoalho da boca, tônus diminuído e mobilidade normal.853860Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

The effects of frenotomy on breastfeeding

Although the interference of tongue-tie with breastfeeding is a controversial subject, The use of lingual frenotomy has been widely indicated by health professionals. Objective : To observe changes in breastfeeding patterns after lingual frenotomy concerning the number of sucks, pause length between groups of sucking and mother's complaints. Material and Methods : Oral yes/no questions about breastfeeding symptoms and sucking/swallowing/breathing coordination were answered by the mothers of 109, 30 day old infants. On the same day the infants had their lingual frenulum assessed by administering a lingual frenulum protocol. After the assessment, all tongue-tied infants were referred for frenotomy; nevertheless, only 14 underwent the surgery. Of the 109 infants, 14 infants who did not have frenulum alterations were included as controls. Birth order and gender were the criteria for recruiting the control group. The tongue-tied infants underwent lingual frenotomy at 45 days of age. At the conclusion of the frenotomy, the infants were breastfed. At 75 days old, both groups – control and post-frenotomy – were reassessed. Before the reassessment the same oral yes/no questions were answered by the mothers of the 14 infants who underwent frenotomy. The mothers of the control group answered the questionnaire only at the time of the first assessment. Data were subjected to statistical analysis. Results : After frenotomy, the number of sucks increased and the pause length between sucking decreased during breastfeeding. The controls maintained the same patterns observed in the first assessment. From the questionnaire answered by the mothers of the 14 tongue-tied infants, at 30 days and 75 days, we observed that the symptoms concerning breastfeeding and sucking/swallowing/breathing coordination were improved after lingual frenotomy Conclusions : after lingual frenotomy, changes were observed in the breastfeeding patterns of the the tongue-tied infants while the control group maintained the same patterns. Moreover, all symptoms reported by the mothers of the tongue-tied infants had improved after frenotomy

The effects of frenotomy on breastfeeding

Although the interference of tongue-tie with breastfeeding is a controversial subject, The use of lingual frenotomy has been widely indicated by health professionals. To observe changes in breastfeeding patterns after lingual frenotomy concerning the number of sucks, pause length between groups of sucking and mother's complaints. Oral yes/no questions about breastfeeding symptoms and sucking/swallowing/breathing coordination were answered by the mothers of 109, 30 day old infants. On the same day the infants had their lingual frenulum assessed by administering a lingual frenulum protocol. After the assessment, all tongue-tied infants were referred for frenotomy; nevertheless, only 14 underwent the surgery. Of the 109 infants, 14 infants who did not have frenulum alterations were included as controls. Birth order and gender were the criteria for recruiting the control group. The tongue-tied infants underwent lingual frenotomy at 45 days of age. At the conclusion of the frenotomy, the infants were breastfed. At 75 days old, both groups – control and post-frenotomy – were reassessed. Before the reassessment the same oral yes/no questions were answered by the mothers of the 14 infants who underwent frenotomy. The mothers of the control group answered the questionnaire only at the time of the first assessment. Data were subjected to statistical analysis. After frenotomy, the number of sucks increased and the pause length between sucking decreased during breastfeeding. The controls maintained the same patterns observed in the first assessment. From the questionnaire answered by the mothers of the 14 tongue-tied infants, at 30 days and 75 days, we observed that the symptoms concerning breastfeeding and sucking/swallowing/breathing coordination were improved after lingual frenotomy. After lingual frenotomy, changes were observed in the breastfeeding patterns of the the tongue-tied infants while the control group maintained the same patterns. Moreover, all symptoms reported by the mothers of the tongue-tied infants had improved after frenotomy.23215315