Closure of maxillary lateral incisor agenesis space in unilateral cleft lip and palate: a digital model assessment

ABSTRACT Objective: To compare dental positional and gingival parameters of maxillary anterior teeth in unilateral cleft lip and palate (UCLP) after orthodontic treatment with canine substitution due to lateral incisor agenesis. Methods: This split-mouth study comprised 57 subjects with UCLP (31 male, 26 female) and agenesis of maxillary lateral incisor at the cleft side, from a single center. Canine substitution was completed after the secondary alveolar bone graft. Dental models were taken between 2 to 6 months after debonding (mean age: 20.4 years). The following variables were measured in the maxillary anterior teeth: crown height, width, proportion, and symmetry, as well as steps between incisal edges, gingival margins, tooth mesiodistal angulation and labiolingual inclination. Paired t-tests with Bonferroni post-hoc correction was used for comparisons between cleft and non-cleft sides (p<0.05). Results: At the cleft side, canines replacing missing lateral incisors had a higher crown height (0.77mm) and an increased width (0.67mm), and first premolars showed a shorter crown height (1.39mm). Asymmetries were observed in the gingival level of central and lateral incisors, with a greater clinical crown at the cleft side (0.61 and 0.81mm, respectively). Cleft side central incisors were more upright than their contralaterals (2.12º). Conclusions: Maxillary anterior teeth demonstrated positional, size and gingival height differences between cleft and non-cleft side after space closure of maxillary lateral incisor agenesis. Slight asymmetries in tooth position and gingival margin in the maxillary anterior teeth should be expected after orthodontic treatment in UCLP patients.

RESUMO Objetivo: O presente trabalho teve como objetivo comparar parâmetros dentários posicionais e gengivais de dentes anteriores superiores em pacientes com fissura labiopalatina transforame unilateral (FLPTU) após tratamento ortodôntico com substituição de incisivo lateral ausente por canino, devido a agenesia. Métodos: Esse estudo de boca dividida reuniu uma amostra, de um mesmo centro especializado de tratamento, de 57 indivíduos com FLPTU (31 homens, 26 mulheres) e agenesia do incisivo lateral superior no lado da fissura. A substituição do incisivo lateral por um canino foi concluída após o enxerto ósseo alveolar secundário. Os modelos dentários foram obtidos entre dois e seis meses após a remoção do aparelho (idade média: 20,4 anos). Foram mensuradas nos dentes anteriores as variáveis: altura, largura, proporção e simetria da coroa, bem como as distâncias entre as bordas incisais, margens gengivais, angulação mesiodistal e inclinação vestibulolingual. O teste t pareado com correção post-hoc de Bonferroni foi usado para comparações entre os lados fissurados e não fissurados (p<0,05). Resultados: No lado fissurado, os caninos que substituíram os incisivos laterais ausentes apresentaram uma altura de coroa maior (0,77 mm) e uma largura aumentada (0,67 mm). Os primeiros pré-molares apresentaram uma altura de coroa menor (1,39 mm). Assimetrias foram observadas no nível gengival dos incisivos centrais e laterais, com maior coroa clínica no lado fissurado (0,61 e 0,81mm, respectivamente). Os incisivos centrais do lado fissurado estavam mais intruídos do que os contralaterais (2,12 mm). Conclusão: Os dentes anteriores superiores demonstraram diferenças de posição, tamanho e altura gengival entre os lados fissurado e não fissurado, após o fechamento do espaço da agenesia dos incisivos laterais superiores. Leves assimetrias na posição do dente e margem gengival nos dentes anteriores superiores devem ser esperadas após o tratamento ortodôntico em pacientes com fissura labiopalatina transforame unilateral.

Salivary Cortisol and Sustained Auditory Attention in Children with and without Cleft Lip and Palate

Abstract Introduction Cortisol is a hormone involved in the response to stress. Attention is a function that can change due to exposure to stress. Objectives To verify the correlation between the level of salivary cortisol and sustained auditory attention in children with cleft lip and palate, as well as to compare the results of the variables analyzed between female and male patients. Methods In total, 103 children aged 6 to 11 years, were divided into 2 groups: those with cleft lip and palate (experimental group, EG; n = 69) and the control group (CG; n = 34). The Sustained Auditory Attention Ability Test (SAAAT) and salivary cortisol levels, measured by an enzyme immunoassay kit (Salimetrics, Stage College, PA, US), were calculated and compared regarding the two groups. The statistical tests used were the Mann-Whitney test and the Spearman correlation. Results The median level of salivary cortisol was of 0.03615 μl/dL and 0.18000 μl/dL respectively for the EG and CG, with a significant difference between the groups (p =0.000). Absence of statistical significance (total error score = 0.656; vigilance decrement = 0.051) was observed the for SAAAT among the EG (median total error score = 12.00; 25th percentile [25%] = 7.00; 75th percentile [75%] = 21.00; and vigilance decrement = 1.00; 25% = 0.00; 75% = 2.50) and the CG (median total error score = 12.00; 25% = 6.00; 75% = 24.00; and vigilance decrement = 0.00; 25% = -1.00; 75% = 2.00). Conclusion All children had median levels of salivary cortisol and scores for sustained auditory attention within normal parameters. A significant correlation between the level of salivary cortisol and the ability to sustain auditory attention was observed in children without cleft lip and palate. There were no differences regarding the SAAAT and salivary cortisol between female and male patients.

Preliminary Study of the Applicability of Software in the Investigation of Sustained Auditory Attention

Abstract Introduction The use of auditory behavioral tests, which specifically assess sustained attention, is necessary, due to its relationship with learning, language production, cognitive development and school performance. Objective To evaluate how children performed using software developed to investigate the ability of sustained auditory attention, and to compare the scores obtained in this format with those of the original, non-computerized test. Methods This cross-sectional study included 52 children of both genders, aged 6 to 11 years, with normal hearing and no history of complaints regarding inattention and/or hyperactivity. The computerized test was administered to all 52 children. The total error score (inattention and impulsivity) and the vigilance decrement were used to define the children's performance when using the software. The scores obtained in the two formats (computer software and original on compact disc) were then compared. Results Statistically significant differences were found in the scores for innattention, impulsivity, and total error score (inattention and impulsivity) when comparing genders, and a negative correlation coefficient was found when comparing ages. Increased scores were found for all variables of the sustained auditory attention ability test (SAAAT) compared with the original format. Conclusion Females performed worse than males in all aspects except for vigilance decrement when using the SAAATsoftware developed to evaluate the ability of SAAAT vigilance; younger children made more errors when using the SAAAT software; inattention errors were more frequent than impulsivity. Overall, higher values were obtained using the SAAAT software, when compared with the original version.

The impacts of oral health-related quality of life of elderly people living at home: a cross-sectional study / Impactos da qualidade de vida relacionada à saúde bucal de idosos em domicílio: estudo transversal

Abstract The scope was to verify the impact of oral and sociodemographic conditions, the dental treatment needs and dental pain, on the quality of life of the elderly. This cross-sectional study was conducted in 15 primary health care areas. A backward multivariate linear regression model was used (p<0.05) with oral health related-quality of life as dependent variable. There were 335 elderly people with predominance of women (56.72%) and aged up to 74 years (59.40%). Those who had up to 8 years of education predominated (87.46%), and those who were still working were the minority (13.43%). Multivariate linear regression (p<0.05) showed association with missing teeth (β=0,12; IC 0,00:0,04; p<0,04) and dental prosthesis needs (β=0,14; IC 0,13:0,81; p<0,01), women (β=0,18; IC 0,23:0,85; p<0,01), less aged (β=-0,12; IC -0,05:0,00; p<0,02), not working (β=-0,15; IC -1,09:-0,20; p<0,01), with dental care need (β=0,24; IC 0,25:0,63; p<0,01) and dental pain (β=0,14; IC 0,10:0,64; p<0,01). Missing teeth, sociodemographic conditions, dental treatment needs and dental pain might impact oral health-related quality of life of elders.

Resumo O objetivo foi verificar o impacto da condição bucal e sociodemográfica, necessidade de tratamento odontológico e dor dentária na qualidade de vida de idosos. Este estudo transversal realizou-se em 15 áreas de cuidados primários de saúde. O modelo de regressão linear multivariado foi utilizado (p <0,05) considerando qualidade de vida como variável dependente. Participaram 335 idosos, predomínio de mulheres (56,72%) com idade até 74 anos (59,40%). Ter até 8 anos de estudo predominou (87,46%) e os que trabalhavam eram minoria (13,43%). A regressão linear multivariada (p <0,05) apresentou associação da qualidade de vida com dentes perdidos (β=0,12; IC 0,00:0,04; p<0,04) e necessidade de próteses (β =0,14; IC 0,13:0,81; p<0,01), com mulheres (β=0,18; IC 0,23:0,85; p<0,01), idosos mais jovens (β=-0,12; IC -0,05:0,00; p<0,02), que não trabalham (β=-0,15; IC -1,09:-0,20; p<0,01), com necessidades de tratamento odontológico (β=0,24; IC 0,25:0,63; p<0,01) e dor dentária (β=0,14; IC 0,10:0,64; p<0,01). Dentes perdidos, aspectos sociodemográficos, necessidade de tratamento odontológico e dor dentária podem impactar a qualidade de vida relacionada à saúde bucal de idosos.

Adult Perfomance on the Sustained Auditory Attention Skill Test

Abstract Introduction The Sustained Auditory Attention Ability Test (SAAAT) is an instrument used to assess sustained auditory attention in children. Difficulties related to this ability are not unique to children alone, as adults have been observed to present with the same deficits. Therefore, there is a need to adapt instruments like the SAAAT and provide reference values for adults. Objective To assess adult performance on the SAAAT. Methods Approved by the Human Research Ethics Committee under n° 034/2011. The sample consisted of 30 participants aged between 18 and 30 years old (average age = 24.2 years old), female and male. The inclusion criteria were: peripheral hearing within normal limits, type A tympanometric curve, and no attention-related complaints. The participants were submitted to Tonal Audiometry, Logoaudiometry, Immitanciometry and to the SAAAT. Results The following mean values and standard deviations (SD) were observed: inattention = 1.7 (SD = 2.2) and impulsivity = 0.8 (SD = 0.9) error types. For the SAAAT, the mean value for the total error score was 2.4 (SD = 2.6), and for the decrease in vigilance, it was 0.3 (SD = 0.5). When comparing the performance of adults and children, a statistically significant difference was observed for inattention (p = 0.000) and impulsivity (p = 0.001) error types, as well as in the total error score (p = 0.000) and in decreased vigilance (p = 0.0003). Conclusion The performance of adults in the SAAAT differed from the children's parameters, since adults showed lower scores in all variables of the instrument.

Proximal retention grooves may increase early fracture strength of ART restorations / Sulcos de retenção proximal podem aumentar a resistência a fratura precoce de restaurações de ART

Objective: To evaluate the fracture resistance (RF) of Class II Glass-ionomer Cement (GIC) ART restorations with and without proximal retentions. Material and Methods: 20 freshly extracted human molars were used. Forty (40) standard Mesial-Occlusal (MO) and DistalOcclusal (DO) preparations (20 for each material) were performed with a 245 bur. The unprepared surfaces of the teeth were protected with nail polish and the specimens submerged in 0.5Mol EDTA solution, pH 7.4 for 8h under stirring. The preparations were finished with dentine spoons and 50% received proximal retention with # 3 excavators. 20 cavities were restored with Chemfil Rock (10 with retention and 10 without retention) and 20 cavities were restored with Equia Fil (10 with retention and 10 with no retention) and were stored in an oven at 37ºC and 100% relative humidity for 24h and submitted to axial compression loading in Test Machine - EMIC at a rate of 0.5 mm / minute, until restoration fracture occurred. The values were analyzed by two-way ANOVA (p<0.05). Results: ChemFil Rock presented 300.84 (69.20) (without retention) and 361.70 (81.08) (with retention) and Equia Fil showed 314.60 (69.97) (without retention) and 366.67 (103.38) (with retention). Data obtained with retention were statistically superior to those obtained with non-retained ART restorations (p=0.014). No statistical differences were detected between materials (p=0.761). Conclusion: Retentive grooves improved fracture resistance of Class II GIC ART restorations. (AU)

Objetivo: avaliar a resistência à fratura (FR) de restaurações de ART de Classe II de Cimento de ionômero de vidro (CIV) com e sem retenções proximais. Material e Métodos: Foram utilizados 20 molares humanos recém-extraídos. 40 cavidades padronizadas no sentido Mesial-Oclusal (MO) e Oclusal-Distal (OD) (20 para cada material) foram realizadas com uma broca 245. Os preparos cavitários foram submersos em solução 0,5 mol Mol EDTA, pH 7,4 por 8h sob agitação e foram finalizados com colheres de dentina, nos quais 50% receberam retenções proximais com escavadores #3. 20 cavidades foram restauradas com Chemfil Rock (10 com e 10 sem retenção) e 20 cavidades foram restauradas com Equia Fil (10 com e 10 sem retenção) e armazenadas em estufa a 37ºC e 100% de umidade relativa por 24h e submetidos a carga axial de compressão na máquina de ensaios EMIC a uma taxa de 0,5mm/min, até que a fratura de restauração ocorresse. Os valores foram analisados por ANOVA twoway (p<0,05). Resultados: ChemFil Rock apresentou 300.84 (69.20) (sem retenção) e 361.70 (81.08) (com retenção) e o Equia Fil apresentou 314.60 (69.97) (sem retenção) e 366.67 (103.38) (com retenção). Os dados obtidos com retenção foram estatisticamente superiores àqueles sem retenção (p=0.014). Não houve diferença estatística entre os materiais (p=0.761). Conclusão: Os sulcos retentivos melhoraram a resistência à fratura de restaurações de ART de Classe II de Cimento de ionômero de vidro (CIV).(AU)

Assessment of spontaneous resolution of idiopathic bone cavity

Abstract Idiopathic Bone Cavity (IBC) or Simple Bone Cyst (SBC) is a non- epithelialized bone cavity with serosanguinous fluid content or empty. There is a literature debate regarding its pathogenesis that remains unclear. The main treatment option is the surgical exploration, although there are successful cases described in the literature in which just a follow-up with clinical and radiographic evaluation was performed. Objective This study aimed to assess the spontaneous resolution of idiopathic bone cavity untreated by surgery. Material and Methods Twenty-one patients diagnosed with surgically untreated IBC were submitted to a follow-up protocol modified from Damante, Guerra, and Ferreira5 (2002). A clinical and radiographic evaluation was performed in 13 patients (13/21), while eight patients (8/21) were only radiographically evaluated. Three observers evaluated the panoramic radiographs of 21 patients and the Kappa test was performed by intra and inter-examiners. Inductive and descriptive statistics were applied to the results. Results Only one patient had a positive response to palpation and percussion of the teeth in the cyst area. Most of the cysts evaluated were rated as 3 (lesion "in involution"), 4 (lesion "almost completely resolved"), or 5 ("completely resolved"). Conclusions We observed progressive spontaneous resolution of IBC. Most cysts were found in the recovery process in different follow-up periods. Patient's follow-up, without surgery, may be considered after the diagnosis based on epidemiological, clinical, and radiographic features of the lesion.

Problemas comportamentais em crianças pré-escolares com fissura labiopalatina / Problemas de conducta en niños preescolares con fisuralabiopalatina / Behavioral problems in preschool children with orofacial clefts

O presente estudo objetivou identificar problemas de comportamento de 83 crianças com fissura labiopalatina e testar a correlação entre esses problemas e as variáveis sexo, idade e tipo de fissura. Os instrumentos utilizados foram: Protocolo de Entrevista e o CBCL.Procedeu-se a análise descritiva dos dados utilizando medidas de frequência e porcentagem e,para as associações, foi realizado o Teste Estatístico do Qui-quadrado. Os resultados mostraram maior frequência de problemas de comportamento externalizantes em meninos. Verificou-se porcentagem maior de problemas internalizantes (62,2%) e problemas totais (46,7%) em crianças mais velhas. Quanto à relação entre tipo de fissura e problemas comportamentais pode-se constatar a prevalência de comportamentos internalizantes, independentemente do tipo. Considerando o perfil comportamental que compõem as escalas internalizantes e externalizantes, foi observada uma associação entre sexo e comportamento agressivo, com destaque para os meninos; idade e comportamento agressivo, com destaque para 3 a 4 anos e 3 meses e, tipo de fissura pré-forame e transforam e e comportamento internalizante, com destaque para os problemas de ansiedade/depressão (50% e 27,1% respectivamente). Considera-se que tais dados podem contribuir para o planejamento de ações preventivas e interventivas, uma vez que comportamentos internalizantes e externalizantes reduzem as oportunidades de interações adequadas e, consequentemente, de desenvolvimento social.

Este estúdio objetivó identificar los problemas de comportamiento de 83 niños con fisura de lábio y paladar e probar la correlación entre estos problemas y el género, la edad y el tipo de fisura. Los instrumentos utilizados fueron: Protocolo de Entrevista y el CBCL. Se procedió al análisis descriptivo de los datos utilizando medidas de frecuencia y porcentaje, y para las asociaciones, se realizó la prueba estadística de Chi-cuadrado. Los resultados mostraron una mayor frecuencia de problemas de comportamiento exteriorizado en los niños. Se encontró un mayor porcentaje de problemas de internalización (62.2%) y problemas totales (46.7%) en niños de más edad. La relación entre el tipo de fisura y problemas de comportamiento puede observar la prevalencia de conductas de internalización, independientemente del tipo. Teniendo en cuenta el perfil de comportamiento presentes en escalas de internalización y externalización, se observó una asociación entre el sexo y el comportamiento agresivo, especialmente para los niños; la edad y el comportamiento agresivo, especialmente para 3 a 4 años y 3 meses y, el tipo de fisura pre-foramen y transforamen y comportamiento de internalización, poniendo de relieve problemas de ansiedad /depresión (50% y 27.1%, respectivamente). Se considera que estos datos pueden contribuir al desarrollo de acciones preventivas y de intervención, ya que los comportamientos de internalización y externalización reducen las oportunidades de interacción adecuados y, por tanto, el desarrollo social.

The present study aimed to evaluate behavioral problems in 83 children with orofacial clefts and to test for possible correlations between these problems and the following variables: gender, age and cleft type. The instruments used were: Interview Protocol and the CBCL. Descriptive analysis of the data was performed using measures of frequency and percentage and the Chi-squared test was used to test for possible correlations. The results showed a higher frequency of externalizing behavior problems in boys. Higher rates of internalizing problems (62.2%) and total problems (46.7%) were also found in older children. Regarding the relationship between cleft type and behavioral problems, a prevalence of internalizing behaviors was observed, regardless of the type. Considering the behavioral profile that composes the internalizing and externalizing scales, an association between male gender and aggressive behavior was observed; between the 3 years to 4 years 3 months age group and aggressive behavior; and between the pre-incisive foramen cleft and trans-incisive foramen cleft types and internalizing behavior, with emphasis on anxiety/depression problems (50% and 27.1% respectively). It is considered that these data can contribute to the planning of preventive and interventional actions, as internalizing and externalizing behaviors reduce the opportunity for adequate interactions and, hence social development.

Facial profile esthetics in operated children with bilateral cleft lip and palate

ABSTRACT Objective: The aim of this study was to evaluate the facial profile esthetics of rehabilitated children with complete bilateral cleft lip and palate (BCLP), comparing the judgment of professionals related and not related to cleft rehabilitation and laypersons. Methods: Thirty children in the mixed dentition (24 male; 6 female) with a mean age of 7.8 years were evaluated using facial profile photographs by 25 examiners: 5 orthodontists and 5 plastic surgeons with experience in cleft care, 5 orthodontists and 5 plastic surgeons without experience in oral cleft rehabilitation and 5 graduated laymen. Their facial profiles were classified into esthetically unpleasant (grade 1 to 3), esthetically acceptable (grade 4 to 6), and esthetically pleasant (grade 7 to 9). Intraexaminer and interexaminer errors were evaluated using Spearman correlation coefficient and Kendall's test, respectively. Inter-rater differences were analyzed using Friedman test and Student-Newman-Keuls test for multiple comparisons. Results: Orthodontists dealing with oral clefts rehabilitation considered the majority of the sample as esthetically pleasant. Plastic surgeons of the cleft team and laypersons classified most of the sample as esthetically acceptable. Most of the orthodontists and plastic surgeons not related to cleft care evaluated the facial profile as esthetically unpleasant. The structures associated to unpleasant profiles were the nose, the midface and the upper lip. Conclusions: The facial profile of children with BCLP was classified as esthetically acceptable by laypersons. Professionals related to cleft rehabilitation were more lenient and those not related to cleft care were stricter to facial esthetics than laypersons.

RESUMO Objetivo: o objetivo desse estudo foi avaliar a estética do perfil facial de crianças com fissura labiopalatina completa bilateral (FLCB) operadas, comparando o julgamento de leigos e de profissionais relacionados e não relacionados à reabilitação de fissuras. Métodos: fotografias do perfil facial de trinta crianças na dentadura mista (24 do sexo masculino e 6 do sexo feminino), com idade média de 7,8 anos, foram avaliadas por 25 examinadores: 5 ortodontistas e 5 cirurgiões plásticos com experiência em fissuras, 5 ortodontistas e 5 cirurgiões plásticos sem experiência na reabilitação de fissuras, e 5 leigos com formação superior. Os perfis faciais foram classificados como esteticamente desagradável (grau 1 a 3), esteticamente aceitável (grau 4 a 6) e esteticamente agradável (grau 7 a 9). Para verificar a concordância intraexaminadores e interexaminadores, foram utilizados o Coeficiente de Correlação de Spearman e o Coeficiente de Concordância de Kendall, respectivamente. Para comparação entre as categorias de acordo com os escores atribuídos, foram aplicados o teste de Friedman e o teste de Student-Newman-Keuls, para comparações múltiplas. Resultados: os ortodontistas que lidam com reabilitação de fissuras labiopalatinas consideraram a maioria da amostra como esteticamente agradável. Cirurgiões plásticos com experiência em fissuras e leigos classificaram a maioria da amostra como esteticamente aceitável. Grande parte dos ortodontistas e cirurgiões plásticos sem experiência na reabilitação de fissuras classificou o perfil facial como esteticamente desagradável. As estruturas associadas aos perfis desagradáveis foram o nariz, o terço médio da face e o lábio superior. Conclusões: o perfil facial de crianças com FLCB foi classificado como esteticamente aceitável pelos leigos; já os profissionais relacionados à reabilitação de fissuras foram mais complacentes, em comparação aos profissionais sem experiência na reabilitação de fissuras, que, por sua vez, foram mais rigorosos quanto à estética facial do que os leigos.

Ansiedade Materna e Problemas Comportamentais de Crianças com Fissura Labiopalatina / Maternal Anxiety and Behavioral Problems of Children with Cleft Lip and Palate / Ansiedad Materna y Problemas Conductuales de Niños con Fisura Labiopalatina

Resumo Indicadores emocionais maternos como a ansiedade têm sido considerados como condições de adversidade ao desenvolvimento infantil. São observadas peculiaridades e uma diversidade de achados em relação a problemas de comportamento e a outros distúrbios debilitantes em crianças ao longo do ciclo vital. O presente estudo objetivou identificar e associar indicadores clínicos para a ansiedade materna com os indicadores de problemas de comportamento (internalizantes e externalizantes) de 83 crianças com fissura labiopalatina, com idade entre três e cinco anos. Os instrumentos utilizados foram: protocolo de entrevista, Idate e CBCL. Os resultados apontaram que as crianças que convivem com mães com indicadores clínicos para ansiedade apresentaram prevalência de comportamentos internalizantes (p < 0,001) e externalizantes (p < 0,001). Para os meninos (37,5%) seriam identificados mais problemas de comportamento externalizantes enquanto que para as meninas (60,0%), mais problemas de comportamento internalizantes. Das mães identificadas com ansiedade avaliaram suas crianças como clínicas em problemas externalizantes (p = 0,020 e < 0,001). Considera-se que tais dados podem contribuir para o planejamento de ações preventivas e interventivas, de modo a favorecer o suporte psicológico para as mães que apresentam indicadores clínicos para ansiedade, assim como propor medidas para os problemas comportamentais das crianças que convivem com mães ansiosas....(AU)

Abstract Maternal emotional indicators such as anxiety have been considered as conditions of adversity to child development, and peculiarities and diversity of findings have been observed in relation to behavioral problems and other debilitating disorders in children across the life cycle. The present study aimed to identify and associate clinical indicators for maternal anxiety along with indicators of behavioral problems (internalizing and externalizing) of 83 children with cleft lip and palate, aged between three and five years old. The instruments used were: Interview Protocol, IDATE and CBCL. The results indicated that children who live with mothers with clinical indicators for anxiety showed prevalence of internalizing (p < 0.001) and externalizing (p < 0.001) behaviors; in boys (37.5%) were identified more externalizing behavioral problems while in girls (60.0%) were identified more internalizing behavioral problems. Children with mothers identified with anxiety were evaluated as clinical in externalizing problems (p = 0.020 e < 0.001). It is considered that such data can contribute to the planning of preventive and interventional actions, in order to promote psychological support for mothers who have clinical indicators for anxiety, and to propose measures for the behavioral problems of children living with anxious mothers....(AU)

Resumen Indicadores emocionales maternos como la ansiedad han sido considerados como condiciones adversas al desarrollo infantil, observándose peculiaridades y resultados con relación a problemas de conducta y a otros disturbios debilitantes en niños a lo largo del ciclo vital. El presente estudio tuvo como objetivo identificar y asociar indicadores clínicos de ansiedad materna con los indicadores de problemas de comportamiento (internalizantes y externalizantes) de 83 niños con fisura labio-palatina, con edades entre tres y cinco años. Los instrumentos utilizados fueron: protocolo de entrevista, Idate y CBCL. Los resultados señalaron que los niños que conviven con madres con indicadores clínicos de ansiedad presentaron prevalencia de conductas internalizantes (p < 0,001) y externalizantes (p < 0,001), siendo que para los varones (37,5%) serían identificados más problemas de comportamientos externalizantes y para las niñas (60,0%) más problemas de comportamientos internalizantes. Las madres identificadas con ansiedad evaluaron a sus niños como clínicos en problemas externalizantes (p = 0,020 e < 0,001). Consideramos que estos datos pueden contribuir para el planeamiento de acciones de prevención e intervención con la finalidad de favorecer el apoyo psicológico a las madres que presentaron indicadores clínicos de ansiedad, así como para proponer medidas para los problemas de conducta de los niños que viven con madres ansiosas....(AU)

Speech nasality and nasometry in cleft lip and palate / Nasalidade de fala e nasometria nas fissuras labiopalatinas

ABSTRACT INTRODUCTION: Perceptual evaluation is considered the gold standard to evaluate speech nasality. Several procedures are used to collect and analyze perceptual data, which makes it susceptible to errors. Therefore, there has been an increasing desire to find methods that can improve the assessment. OBJECTIVE: To describe and compare the results of speech nasality obtained by assessments of live speech, the Test of Hypernasality (THYPER), assessments of audio recorded speech, and nasometry. METHODS: A retrospective study consisting of 331 patients with operated unilateral cleft lip and palate. Speech nasality was assessed by four methods of assessment: live perceptual judgement, THYPER, audio-recorded speech sample judgement by multiple judges, and nasometry. All data were collected from medical records of patients, with the exception of the speech sample recording assessment, which was carried out by multiple judges. RESULTS: The results showed that the highest percentages of absence of hypernasality were obtained from judgements performed live and from the THYPER, with equal results between them (79%). Lower percentages were obtained from the recordings by judges (66%) and from nasometry (57%). CONCLUSION: The best results among the four speech nasality evaluation methods were obtained for the ones performed live (live nasality judgement by a speech pathologist and THYPER).

Resumo Introdução: A avaliação perceptiva é considerada padrão-ouro para avaliar a nasalidade de fala. Vários procedimentos são utilizados para coletar e analisar os dados percebidos, o que a torna suscetível a erros. Por isso, há uma preocupação crescente na procura de métodos que possam aperfeiçoá-la. Objetivo: Descrever e comparar os resultados da nasalidade de fala obtidos por meio de julgamento ao vivo, Teste de Hipernasalidade (THIPER), julgamento de gravações por juízes e nasometria. Método: Estudo retrospectivo de 331 pacientes com fissura labiopalatina unilateral operada. Foi realizada a análise dos resultados do julgamento da nasalidade ao vivo e por meio de gravações por juízes, do THIPER e da nasometria. Os dados foram coletados do prontuário dos pacientes, com exceção do julgamento das gravações das amostras de fala, que foi realizado por juízes múltiplos. Resultados: Foram obtidas porcentagens mais altas de ausência de hipernasalidade no julgamento ao vivo e no THIPER, com resultados iguais entre ambas (79%). Porcentagens menores de ausência de hipernasalidade foram obtidas no julgamento das gravações por juízes (66%) e para a nasometria (57%). Conclusão: Os melhores resultados entre as quatro modalidades de avaliação da nasalidade de fala foram obtidos para as realizadas ao vivo (julgamento por um fonoaudiólogo e THIPER).

Interferência dos bicos ortodônticos e convencionais no sistema estomatognático: revisão sistemática / Interference of conventional and orthodontic nipples in system stomatognatic: systematic review

RESUMO Objetivo: Verificar se o tipo de bico, ortodôntico ou convencional, de chupeta e mamadeira, tem alguma influência sobre as alterações encontradas no sistema estomatognático causadas pela manutenção do hábito de sucção. Estratégia de pesquisa: Por meio de uma revisão de literatura sistemática com metanálise, realizada a partir das bases de dados Lilacs, Medline e Embase e com a ferramenta de busca Google Acadêmico™, com os seguintes descritores em português e inglês: “Má oclusão” + “Chupetas”; “Má oclusão” + “Alimentação Artificial”; “Má oclusão” + “Mamadeira”, além das palavras “Bico Ortodôntico” + “Bico Convencional”. Critérios de seleção: Foram incluídos estudos que apresentassem em seus métodos a comparação de grupos que utilizaram chupeta e/ou mamadeira com bico convencional com grupos que utilizaram o bico ortodôntico, sem delimitação temporal. Análise dos dados: A análise do artigo na íntegra foi realizada de modo sistemático, com as seguintes categorias tabelando os resultados pertinentes: objetivo, método - casuística e avaliação, resultados e conclusão. Resultados: Foram encontrados 1.041 trabalhos, período de 1969 a 2013, desses foram excluídos 848 trabalhos, devido aos critérios de exclusão, e outros 174 que eram repetições. Foram lidos na íntegra 19 trabalhos, dos quais quatro artigos atenderam aos critérios de inclusão propostos, e três trabalhos foram incluídos na metanálise. Tais resultados expressaram que não há diferenças significantes entre os bicos ortodôntico e convencional quanto às implicações no sistema estomatognático. Conclusão: Não há possibilidade de concluir a existência de diferenças quanto às consequências no sistema estomatognático ocasionadas por bicos convencionais e ortodônticos de chupetas/mamadeiras.

ABSTRACT Purpose: Check if the type of nozzle, orthodontic or conventional, of pacifier and bottle have any influence on the changes found in the stomatognathic system caused by the maintenance of the sucking habit. Research Strategies: Through a systematic literature review with meta-analysis, performed from the databases Lilacs, Medline and Embase and Scholar Google, with the following key words in Portuguese and English: “malocclusion” + “Pacifiers “; “Malocclusion” + “Bottle Feeding”; “Malocclusion” + “Bottle feeding” beyond words “Orthodontic Beak” + “Conventional Beak”. Selection Criteria: We included studies that presented in their methods to compare groups who used pacifiers and/or bottle with conventional nozzle with groups using orthodontic nipple without temporal delimitation. Data Analysis: The analysis of the article in its entirety was performed systematically, ordering the relevant results in the following categories: objective, method—case studies and evaluation, results, and conclusion. Results: Found 1,041 jobs, from the period 1969 to 2013, 848 jobs were excluded based on the exclusion criteria and another 174 that were repetitions. A total of 19 articles were read in full of which 4 articles met the proposed inclusion criteria, and three studies were included in the meta-analysis. These results show that there are no significant differences between the orthodontic and conventional nozzles on the implications of the stomatognathic system. Conclusion: There is no way to conclude that there are differences as to the consequences to the stomatognathic system caused by conventional nozzles and orthodontic pacifier/bottle.

Estilo de vida em pacientes portadores de diabetes mellitus tipo 1: uma revisão sistemática / Lifestyle of patients with diabetes mellitus type 1: a systematic review

Resumo O objetivo desta revisão foi verificar dados concernentes sobre a relação existente entre estilo de vida e controle glicêmico em pacientes com Diabetes Mellitus tipo 1 (DM1). Os métodos aplicados incluíram estratégia de busca na literatura, seleção dos estudos por meio dos critérios de inclusão e exclusão de acordo com as características dos estudos. A busca foi realizada nas bases de dados Lilacs, Medline, PubMed, Cochrame, SciELO e IBECS entre 2005 e 2014. Os artigos selecionados foram estudos em humanos, investigando estilo de vida, atividades físicas e níveis glicêmicos. Dos 1798 estudos identificados inicialmente, 11 atendiam aos critérios de elegibilidade. Dentre os estudos analisados foram relacionados 1 de coorte, 1 longitudinal prospectivo, 1 caso controle e 8 transversais que abordavam o tema proposto. A atividade física regular foi a variável que apresentou maior relação com a melhora nos níveis glicêmicos. Vida ativa saudável, dieta balanceada, atividades físicas e educação em diabetes melhoraram o controle glicêmico do paciente DM1. Os resultados permitem concluir que o estilo de vida pautado em atividades físicas interfere diretamente na saúde do paciente com DM1, inclusive contribuindo para o controle glicêmico.

Abstract The aim of this review was to verify data concerning the relationship between the existent lifestyle and glycemic control in patients with Diabetes Mellitus Type 1 (DM1). The methods applied included the literature search strategy, selection of studies by means of inclusion and exclusion strategies, according to the characteristics of the studies. The search was conducted in the Lilacs, Medline, PubMed, Cochrame, SciELO and IBECS databases between in the period between 2005 and 2014. The articles selected were studies in humans, investing lifestyle, physical activities and glycemic levels. Of the 1798 studies initially identified, 11 met the eligibility criteria. Among the studies analyzed, 1 cohort; 1 longitudinal prospective, 1 case control and 8 transversal studies that approached the proposed theme were related. Regular physical activity was the variable that presented greatest relationship with the improvement in glycemic levels. Healthy active life, balanced diet, physical activities and education in diabetes improved the glycemic control of the DM1 patient. The results allowed the authors to conclude that a lifestyle based on physical activities interfered directly in the health of patients with DM1, in addition to contributing the glycemic control.

Correlation of Beta-2 Adrenergic Receptor Expression inTumor-Free Surgical Margin and at the Invasive Front ofOral Squamous Cell Carcinoma

Background. The beta-2 adrenergic receptor is expressed by neoplastic cells and is correlated with a wide spectrum of tumor cell mechanisms including proliferation, apoptosis, angiogenesis, migration, and metastasis. Objectives. The present study aimed to analyze the expression of the beta-2 adrenergic receptor (ß2-AR) in tumor-free surgical margins of oral squamous cell carcinomas (OSCC) and at the invasive front. Sixty-two patients diagnosed with OSCC, confirmed by biopsy, were selected for the study. The clinicopathological data and clinical follow-up were obtained from medical records and their association with ß2-AR expression was verified by the chi-square test or Fischer's exact test. To verify the correlation of ß2-AR expression in tumor-free surgical margins and at the invasive front of OSCCs, Pearson's correlation coefficient test was applied. Results. The expression of ß2-AR presented a statistically significant correlation between the tumor-free surgical margins and the invasive front of OSCC (r = 0.383; p = 0.002). The immunohistochemical distribution of ß2-AR at the invasive front of OSCC was also statistically significant associated with alcohol (p = 0.038), simultaneous alcohol and tobacco consumption (p = 0.010), and T stage (p = 0.014). Conclusions. The correlation of ß2-AR expression in OSCC and tumor-free surgical margins suggests a role of this receptor in tumor progression and its expression in normal oral epithelium seems to be constitutive

Management of painful temporomandibular joint clicking with different intraoral devices and counseling: a controlled study

Objective The benefit of the use of some intraoral devices in arthrogenous temporomandibular disorders (TMD) patients is still unknown. This study assessed the effectiveness of the partial use of intraoral devices and counseling in the management of patients with disc displacement with reduction (DDWR) and arthralgia.Materials and Methods A total of 60 DDWR and arthralgia patients were randomly divided into three groups: group I (n=20) wore anterior repositioning occlusal splints (ARS); group II (n=20) wore the Nociceptive Trigeminal Inhibition Clenching Suppression System devices (NTI-tss); and group III (n=20) only received counseling for behavioral changes and self-care (the control group). The first two groups also received counseling. Follow-ups were performed after 2 weeks, 6 weeks and 3 months. In these sessions, patients were evaluated by means of a visual analogue scale, pressure pain threshold (PPT) of the temporomandibular joint (TMJ), maximum range of motion and TMJ sounds. Possible adverse effects were also recorded, such as discomfort while using the device and occlusal changes. The results were analyzed with ANOVA, Tukey’s and Fisher Exact Test, with a significance level of 5%.Results Groups I and II showed improvement in pain intensity at the first follow-up. This progress was recorded only after 3 months in Group III. Group II showed an increased in joint sounds frequency. The PPT values, mandibular range of motion and the number of occlusal contacts did not change significantly.Conclusion The simultaneous use of intraoral devices (partial time) plus behavioral modifications seems to produce a more rapid pain improvement in patients with painful DDWR. The use of NTI-tss could increase TMJ sounds. Although intraoral devices with additional counseling should be considered for the management of painful DDWR, dentists should be aware of the possible side effects of the intraoral device’s design.

Correlação entre tempo de trânsito oral e faríngeo no acidente vascular cerebral / Correlation between oral and pharyngeal transit time in stroke

Objetivo Correlacionar o tempo de trânsito oral total (TTOT) com o início da resposta faríngea (IRF) e o tempo de trânsito faríngeo (TTF) no indivíduo, após acidente vascular cerebral (AVC).Métodos O estudo incluiu 61 exames de videofluoroscopia de deglutição de indivíduos após AVC hemisférico isquêmico. Destes, 28 eram do gênero masculino e 33 do gênero feminino, com faixa etária variando de 40 a 101 anos (média de 65 anos). Para análise dos resultados, os indivíduos foram divididos em dois grupos. O Grupo 1 (G1) constou de 17 indivíduos com tempo de trânsito oral total até 2000 ms, conforme normalidade, e o Grupo 2 (G2), de 44 indivíduos com tempo de trânsito oral total maior que 2000 ms. Foi realizada análise quantitativa da deglutição orofaríngea. Cada indivíduo foi observado durante a deglutição de uma colher de 5 ml com alimento na consistência pastosa. Foi aplicado o teste de correlação de Spearman.Resultados Não houve correlação entre o G1 e a IRF e o TTF. Houve fraca correlação entre o G2 e os parâmetros estudados.Conclusão O aumento do tempo de trânsito oral total no indivíduo após AVC possui correlação fraca com o aumento do tempo na fase faríngea.

Purpose To correlate the total oral transit time (TOTT) with initiation of pharyngeal response (IPR) and pharyngeal transit time (PTT) in stroke.Methods The study included 61 swallowing videofluoroscopy exams of individuals after hemispheric ischemic stroke. Of these, 28 were male and 33 female, with ages ranging from 40 to 101 years (mean 65 years). For analysis of the results, individuals were divided into two groups. Group 1 (G1) consisted of 17 individuals with TOTT up to 2000 ms, as normality, and Group 2 (G2) consisted of 44 individuals with TOTT greater than 2000 ms. Temporal measurement of oropharyngeal swallowing was performed. Each individual was observed during the swallowing of a 5 mL spoonful of food in puree consistency. The Spearman´s rank correlation coefficient test was applied.Results There was no correlation between G1 and IPR and PTT. There was weak correlation between G2 and the studied parameters.Conclusion The increase of TOTT in the stroke individual has weak correlation with increased time in the pharyngeal phase.

Acoustic reflex on newborns: the influence of the 226 and 1,000 Hz probes / A influência da sonda de 226 e 1.000 Hz no registro do reflexo acústico em neonatos

PURPOSE: To analyze the occurrence of acoustic reflex and its threshold on newborns using the 226 and 1,000 Hz probes. METHODS: Thirty-six newborns with "PASS" results in newborn hearing screening and tympanogram with one or two peaks for both probe tones were included. Group I comprised 20 full-term newborns without risk indicator for hearing loss, and Group II comprised 16 newborns with at least one risk indicator. The study about ipsilateral acoustic reflex thresholds was conducted in 500, 1,000, 2,000, and 4,000 Hz. RESULTS: The groups presented the acoustic reflex thresholds between 50 and 100 dB for both probe tones. In the comparison between the probes, there were differences in all frequencies evaluated in Group I, with the lowest threshold mean for the 1,000 Hz probe. In Group II, differences were detected at 2,000 Hz. The mean acoustic reflex thresholds were similar in both groups for the 226 Hz probe. There was a difference for the 1,000 Hz probe in all tested frequencies. The percentage of response was higher in both groups for the 1,000 Hz probe. The kappa test showed extremely poor agreement in the comparison of results between both probes. CONCLUSION: The occurrence of acoustic reflex was higher in newborns and its thresholds were lower with the 1,000 Hz probe both for healthy newborns and for newborns at risk. .

OBJETIVO: Verificar a ocorrência e o limiar do reflexo acústico em neonatos utilizando a sonda de 226 e 1.000 Hz. MÉTODOS: Trinta e seis neonatos com resultado "PASS" na triagem auditiva neonatal e timpanogramas com um ou dois picos para os dois tons de sonda. O Grupo I foi composto por 20 neonatos a termo sem indicador de risco para deficiência auditiva e o Grupo II, por 16 neonatos com pelo menos um indicador de risco. A pesquisa dos limiares do reflexo acústico ipsilateral foi realizada em 500, 1.000, 2.000 e 4.000 Hz. RESULTADOS: Os grupos apresentaram limiar do reflexo acústico entre 50 e 100 dB para ambos os tons de sonda. Na comparação entre as sondas, houve diferença em todas as frequências avaliadas no Grupo I, com a média de limiares menor com a sonda de 1.000 Hz. No Grupo II, foi detectada diferença em 2.000 Hz. Com a sonda de 226 Hz, os limiares médios do reflexo acústico foram semelhantes nos dois grupos. Com a sonda de 1.000 Hz, houve diferença em todas as frequências avaliadas. A porcentagem de presença de resposta foi maior para ambos os grupos para a sonda de 1.000 Hz. O teste kappa revelou concordância extremamente pobre na comparação dos resultados entre as duas sondas. CONCLUSÃO: A ocorrência de reflexo acústico em neonatos foi maior e os limiares menores com a utilização da sonda de 1.000 Hz, tanto para neonatos saudáveis como para os neonatos de risco. .

Evaluation of the social, clinical and laboratorial profile of patients diagnosed with leprosy in a reference center in São Paulo

BACKGROUND: Leprosy is the main infectious cause of disability. It is said to be eradicated in São Paulo since 2005, but diagnosis is still late. OBJECTIVES: To investigate the social, clinical and laboratorial profile of leprosy patients diagnosed between 01/2007 and 12/2011, in a reference center in São Paulo. METHODS: Retrospective descriptive study. Data of all new leprosy cases diagnosed between 01/2007 and 12/2011 were raised in São Paulo. RESULTS: 103 men and 71 women were diagnosed, most of them were multibacillary. Mean age at diagnosis was 49 yrs; 2,2% were children; 70% had incomplete primary education; 50% were referred without diagnostic suspicion of leprosy. Mean time since first symptoms/signs and diagnosis was 2 years; 64% of patients had some degree of disability, and 26% had grade 2. 23 cases were diagnosed only after being summoned, and 80% of these had no disability. Agreement between the Ridley and Jopling and the WHO classification was 75% (kappa index = 0.44). Serology for IgM anti-PGL1 (87 patients) showed a mean value of 0.25, and an association between MB classification and test positivity (p <0.001). CONCLUSIONS: Leprosy diagnosis in São Paulo is late. The disease mainly affected the socially disadvantaged and economically active population. Failure to detect the disease (41% in the last 10 years) could be due to the lack of suspicion and to decentralization. For the classification of patients with advanced leprosy, both the WHO and R&J classifications proved to be helpful tools. .

Avaliação da nasalidade de fala na fissura labiopalatina / Assessment of speech nasality in individuals with cleft palate

Objetivo Descrever os resultados da nasalidade de fala de indivíduos com fissura labiopalatina e comparar os achados de nasalidade estabelecidos por meio do julgamento perceptivo-auditivo realizado ao vivo com os achados estabelecidos por análise de gravações por juízes, em dois tipos de amostras de fala. Métodos O estudo envolveu a análise retrospectiva dos resultados de avaliações perceptivo-auditivas da nasalidade de fala realizadas ao vivo por uma fonoaudióloga e o julgamento prospectivo, por consenso de juízas de 100 gravações de amostras de fala, obtidas durante a produção de dois conjuntos de estímulos de fala: um com consoantes de alta pressão (CAP, n=100) e outro com consoantes de baixa pressão (CBP, n=100). Os dados pertenciam a pacientes de ambos os gêneros, com idades entre 5 e 12 anos, que tiveram a fissura labiopalatina operada por um mesmo cirurgião. Resultados A ausência de hipernasalidade foi constatada em 69% dos julgamentos ao vivo. Quando presente, a hipernasalidade leve foi constatada em 23% dos casos, enquanto a hipernasalidade moderada em 8%. Para os julgamentos das amostras gravadas, 50% foram identificadas com hipernasalidade durante a produção das amostras CAP e 62% durante a das amostras CBP. Diferença significativa foi encontrada entre o resultado do julgamento ao vivo e o julgamento pelas juízas nas amostras CAP. A concordância entre as modalidades de avaliação variou de 79% para as amostras CAP e 80% para as amostras CBP, sendo considerada moderada. Conclusão O julgamento perceptivo ao vivo da nasalidade de fala pode detectar melhor a ausência de hipernasalidade, seguida pela hipernasalidade de grau leve, em comparação com o julgamento realizado por juízes múltiplos, a partir de amostras gravadas. Contudo, tem a desvantagem de os dados não poderem ser reproduzidos, nem quantificados, nem compartilhados por outros membros da equipe. .

Purpose To describe the results of speech nasality of individuals with cleft lip and palate, and to compare auditory-perceptual judgments of nasality between live ratings and multiple judges ratings of recorded speech, for two sets of speech stimuli. Methods The study involved the retrospective analysis of the results of auditory-perceptual assessments of speech nasality performed live by a single speech-language pathologist and a prospective judgment of 100 recordings of speech samples obtained during production of two sets of speech stimuli: one with high pressure consonants (HPC, n=100) and another with low pressure consonants (LPC, n=100). The data belonged to patients, of both genders, with ages between 5 and 12 years, with cleft lip and palate operated by the same surgeon. Results The absence of hypernasality was found for 69% of the patients during live assessment. When present, mild hypernasality was found for 23% and moderate for 8% of the patients. For judge ratings of recorded samples, 50% was identified as hypernasal during production of samples with high pressure consonants, and 62% for the samples with low pressure consonants. A statistically significant difference was found between the live perceptual judgments and judges’ ratings of the recorded samples only for the stimuli with high pressure consonants. The agreement between the methods of assessment was 79% for HPC samples and 80% for LPC samples, within the moderate range. Conclusion Live perceptual judgment of speech nasality revealed higher occurrence of absence of hypernasality followed by presence of mild hypernasality, when compared to multiple judges of recorded samples. The live clinical assessment of speech, however, has the disadvantage that the data may not be reproduced, quantified or shared by other team members. .

Muscleskeletal pain in dysphonic women / Dor musculoesquelética em mulheres disfônicas

Objective: To investigate the location, frequency and intensity of muscle pain in dysphonic functional/organofunctional women in comparison to women with healthy voices. Methods: Sixty women, ranging in age from 18 to 45 years, divided into two groups: Dysphonic Group (DG) – 30 women with functional or organofunctional dysphonia; Non-Dysphonic Group (NDG) – 30 women without vocal complaints, and with adapted voices. All answered a protocol, marking the localization, frequency and intensity symptoms of pain on the temporal area, masseters, submandibular areas, larynx/pharynx, front and back of the neck, shoulders, upper back, lower back, elbows, fists/hands/fingers, hip/this, knees and ankles/feet. The volunteer should report the frequency in which pain was present in the last 12 months: no, rarely, frequently or always. The intensity of pain was measured by visual-analogue scales. The DG and NDG groups were compared using the Mann-Whitney test (p<0.05). Results: The women of the DG reported significantly greater frequency of submandibular area (p=0.008), laryngeal pain (p<0.001), front of the neck (p=0.015), back of the neck (p=0.001), shoulder pain (p=0.027), upper back (p=0.027) and also reported significant greater intensity of pain in the larynx/pharynx (p=0.022) and back of the neck (p=0.003). Conclusion: The frequency and intensity of musculoskeletal pain was more frequent and more intense in dysphonic women than in women without vocal complaints, showing that pain may be related to functional and organofunctional dysphonia in women.

Objetivo: Investigar a localização, frequência e intensidade da dor muscular em mulheres com disfonia funcional/organofuncional e comparar com um grupo de mulheres com vozes saudáveis. Métodos: Participaram 60 mulheres, entre 18 e 45 anos, divididas em dois grupos: Disfônico (GD) – 30 mulheres com disfonia funcional/organofuncional; Não Disfônico (GND) – 30 mulheres sem queixas vocais, sem alterações vocais. Todas responderam a um protocolo para localização, frequência e intensidade da dor. Foram investigadas as regiões: temporal, masseteres, submandibular, laringe/faringe, parte anterior/posterior do pescoço, ombros, parte superior/inferior das costas, cotovelos, punhos/mãos/dedos, quadril/coxas, joelhos, tornozelos/pés. A voluntária deveria assinalar a frequência em que a dor esteve presente nos últimos 12 meses: não, raramente, com frequência ou sempre. Para mensuração da intensidade da dor, utilizou-se a escala visual analógica. Os grupos foram comparados pelo teste de Mann-Whitney (p<0,05). Resultados: As mulheres do GD relataram maior frequência de dores na região submandibular (p=0,008), região da laringe/faringe (p<0,001), parte anterior (p=0,015) e posterior (p=0,001) do pescoço, ombros (p=0,027) e parte superior das costas (p=0,027) do que as do GND; relataram dor significativamente mais intensa na laringe/faringe (p=0,022) e região posterior do pescoço (p=0,003) quando comparadas ao GND. Conclusão: A frequência e intensidade de dor musculoesquelética foram maiores e mais frequentes nas mulheres disfônicas do que nas sem queixas, revelando que a dor pode estar relacionada às disfonias funcionais e organofuncionais em mulheres.