Atuação da fonoaudiologia na estética facial: relato de caso clínico / Speech therapy performance ih the facial aesthetics: case report

TEMA: estética facial. PROCEDIMENTOS: por meio de anamnese e avaliação clínica, aplicou-se um protocolo de tratamento com manipulação funcional dos músculos mastigatórios faciais acompanhados de exercícios isométricos num total de 8 sessões semanais, durante 2 meses, sendo fotografados antes e após o tratamento. O objetivo foi caracterizar as modificações faciais do ponto de vista qualitativo avaliadas clinicamente após tratamento Fonoaudiológico, num enfoque etiológico de caráter biomecânico. RESULTADOS: observou-se uma melhoria da simetria facial e funções relacionadas à biomecânica mandibular. CONCLUSÃO: sugere-se a importância da atuação fonoaudiológica no restabelecimento facial e funcional da motricidade oral com repercussões na diminuição das rugas, marcas de expressão e flacidez.

BACKGROUND: aesthetics PROCEDURES: by means of a questionnaire and clinical evaluation, we applied a treatment protocol with functional manipulation of the masticatory muscles accompanied by facial isometric exercises for a total of 8 weekly sessions during 2 months, and we photographed before and after treatment. This study aimed at featuring four facial changes in terms of quality, as assessed after treatment, under an etiological and biomechanical character focus. RESULTS: there was an improvement in facial symmetry and functions related to mandibular biomechanics. CONCLUSION: we suggest the importance of speech-language intervention in restoring facial and functional oral motor that influence the reduction of wrinkles, expression marks and flaccidity.

Caries experience associated to social and preventive factors in children of a pastoral community from Limeira-SP

To evaluate caries experience and prevalence associated to social and preventive factors in 3-6-year-old children of a Pastoral Community from Limeira, Brazil. Methods: A cross-sectional study was carried out through an epidemiologic research about the oral conditions of 110 children registered at the Children’s Pastoral Community from the city of Limeira, SP, Brazil. Intraoral examination was performed by a trained dentist and the parents/caregivers filled out a questionnaire in order to outline the children’s profile with respect to gender, parental education and oral health. Results: Differences related to gender were not detected (p= 0.3404). The most frequent periods of breastfeeding were 0 to 2 months (36.36%) and 2 to 6 months (35.45%), corresponding to 71.81% of the cases. The time bottle feeding pointed to two most frequent categories: 1) more than 12 months (35.45%) and 2) between 2 and 6 months (22.63%). Regarding parental education, the majority of the sample has not completed primary school (38.32%). It was observed a larger number of decayed teeth in male children (63.39%). Caries experience was significantly higher in children who were breastfed for only 2 months of life (41.96%). Children that did not use baby bottle or did not use a baby bottle for more than 1 year presented a smaller dmft, corresponding to 29.17% and 28.33%, respectively. Time of use of bottle and pacifier presented a significant association (p<0.05). Conclusions: The implementation of adequate strategies and actions is needed to reinforce oral health conditions in risk groups.

Alterações sialoquímicas e sialométricas de pacientes com paralisia cerebral: uma revisão de literatura / Sialochemical and sialometric alterations in patients with cerebral palsy: a literature review

TEMA: paralisia cerebral e alterações salivares. O paciente com paralisia cerebral é acometido por diversas desordens no Sistema Estomatognático, sendo muitas delas expressas sob a forma de alterações no fluxo e composição salivar. A variação da concentração de constituintes da saliva está diretamente relacionada com sua capacidade tampão, antioxidante, imunológica, digestiva e lubrificante, além de sofrer variações em função da velocidade do fluxo salivar, o qual está intimamente relacionado à eficiência dos estímulos mecânicos e neurais do trato salivar. Alterações na deglutição, da percepção gustativa, do processo de mineralização dos dentes e da propriedade protetora da saliva contra lesões cariosas, infecções e inflamações, freqüentemente observadas em pacientes com paralisia cerebral, podem ser avaliadas pelo exame da saliva. OBJETIVO: realizar uma revisão de literatura relacionando as principais alterações sialométrica e sialoquímica de pacientes com paralisia cerebral e seus efeitos na saúde bucal. CONCLUSÃO: a análise sialométrica e sialoquímica oferece informações extremamente úteis no diagnóstico e no direcionamento do tratamento desses pacientes, e pode ser considerada uma indicadora prática e objetiva dos processos de doença e disfunções.

BACKGROUND: cerebral palsy and salivary alterations. Patients with cerebral palsy frequently suffer from several disorders in the Stomatognathic System, many of them being expressed as alterations in the salivary flow and composition. Variations in the concentration of salivary components are directly related to their buffering, antioxidant, immunological, digestive and lubricant capacity, and vary according to the velocity of salivary flow, which is deeply related to the efficiency mechanical and neural stimuli on salivary tracts. Alterations in the swallowing function, gustative perception, mineralization of teeth process, as well as salivary protection function against caries lesions, infection and inflammation, which are frequently found in patients with cerebral palsy, can be analyzed through salivary exams. PURPOSE: this study aimed to perform a literature review related to the main sialometric and sialochemical alterations observed in patients with cerebral palsy and their effects on oral health. CONCLUSION: sialometric and sialochemical analyses are an objective and practical indicator of disease and dysfunction process and offer extremely useful information on the diagnosis and treatment referral for these patients.

Avaliação cefalométrica da posição do osso hióide em crianças respiradoras bucais / Cephalometric assessment of the hyoid bone position in oral breathing children

MATERIAL E MÉTODOS: em função das relações anatomofuncionais do osso hióide com o complexo craniofacial, realizou-se avaliação cefalométrica da posição do osso hióide em relação ao padrão respiratório. A amostra consistiu de 53 crianças, gênero feminino, com idades médias de 10 anos, sendo 28 respiradoras nasais e 25, bucais. As medidas cefalométricas horizontais, verticais e angulares foram utilizadas com a finalidade de determinar a posição do osso hióide. Estabeleceu-se uma comparação entre os grupos por meio do teste "t" de student, bem como correlação de Pearson entre as variáveis. RESULTADOS: Observou-se que não ocorreram diferenças estatísticas significativas para a posição mandibular e posição do osso hióide e o tipo do padrão respiratório. No Triângulo Hióideo, o coeficiente de correlação de 0,40 foi significativo entre AA-ENP (distância entre vértebra atlas e espinha nasal posterior) e C3-H (distância entre a terceira vértebra cervical e osso hióide) demonstrando uma relação positiva entre os limites ósseos do espaço aéreo superior e inferior. Para as medidas cranianas sugeriu-se uma relação entre a posição do osso hióide com a morfologia mandibular. CONCLUSÃO: Os resultados permitiram concluir que o osso hióide mantém uma posição estável, provavelmente, para garantir as proporções corretas das vias aéreas e não depende do padrão respiratório predominante.

MATERIAL AND METHODS: because of its anatomical and functional relationship with the craniofacial complex, we assessed the cephalometry of the hyoid bone position in relation to the respiratory pattern of these 53 female children, with average age of 10 years; 28 of them are nasal breathers and 25 are oral breathers. Horizontal, vertical and angular cephalometric measures were used in order to determine the hyoid bone location. The Student "t" and the Pearson correlation tests were used in order to compare the groups and the variables. RESULTS: We did not see statistically significant differences in mandible and hyoid bone positions and the respiratory pattern. In the hyoid triangle, the 0.40 correlation coeficient was significant between AA-ENP (distance between the Atlas vertebrae and the posterior nasal spine) and C3-H (distance between the third cervical vertebrae and the hyoid bone) showing a positive relation between the bony limits of the upper and lower air spaces. For cranial measures we have suggested a relationship between the hyoid bone position and the mandible morphology. CONCLUSION: The results led us o conclude that the hyoid bone keeps a stable position, probably in order to secure correct ratios in the airways, and it does not depend on the respiratory pattern.

Cephalometric appraisal of the hyoid triangle in brazilian people of Piracicaba’s region

The Triangle Hyoid was measured by cephalometric measures in Brazilian individuals from Piracicaba’s region by establishing comparisons with the values existing in the literature objectiving to establish values of normality for the position of the hyoid bone. The sample consisted of 31 cephalometric radiographs of Brazilian individuals with Angle’s Class I malocclusion, mix dentition,16 boys and 15 girls with ages raging from 8 to 15 years. The gotten data had submitted it test “t” of Student that showed the occurrence of sexual dimorfism for the ântero-posterior position of the hyoid bone(H) to the retrognation (RGn). The antero-posterior hyoid position (H) in relation to the third cervical vertebra (C3) was constant, with values of 34.03 mm and standard deviation of 3.85. The distances between antero-posterior position of C3 and symphysis (RGn) were similar to those found in the literature. The vertical position of the hyoid bone was higher and less inclined. The correlation coefficient between the atlas vertebrae to posterior nasal espine (AA-PNS) and C3-H was significant (0.56), which is suggesting that the hyoid bone represents the previous limit of the upper airspace in a level more inferior than the PNS in accordance with the literature. It concluded itself that there is a related sexual differences and face standard with the position of the hyoid bone indicates the necessity of a refined evaluation of this bone, therefore represents an important element for the orthodontic and functional orthopedic and speech therapist and physitherapist.