Intervenções da Fonoaudiologia nas áreas de respiração, mastigação, deglutição e fala: uma revisão de escopo / Speech Language Pathology interventions in the areas of breathing, chewing, swallowing and speaking: a scoping review

RESUMO Há diversas abordagens que podem ser utilizadas para atingir os objetivos terapêuticos nos distúrbios relacionados às funções de mastigação, deglutição, fala e respiração. Entretanto, a literatura necessita de evidências que fundamentem o uso na prática clínica fonoaudiológica. O objetivo desta revisão foi mapear as sínteses de evidências sobre intervenção fonoaudiológica nas áreas de respiração, mastigação, deglutição e fala em adultos e idosos.‬ Foram incluídos apenas estudos classificados por seus autores como revisão sistemática, que abordaram terapia para disfunções orofaciais em indivíduos maiores de 18 anos. Os procedimentos realizados foram: busca eletrônica e manual; seleção dos estudos; extração dos dados; avaliação da qualidade dos estudos e análise de dados. Foi possível observar diversos tipos de intervenções principalmente voltadas à função de deglutição, abarcando desde a terapia tradicional até a utilização de dispositivos. Contudo, devido às limitações dos estudos, os dados devem ser interpretados com cautela.

ABSTRACT There are several types of approaches that can be used to achieve therapeutic goals in disorders related to the functions of mastication, swallowing, speech, and breathing. However, the literature lacks evidence to support their use in speech-language clinical practice. The objective of this review was to map the syntheses of evidence on speech-language pathology intervention in the areas of breathing, mastication, swallowing and speech in adults and the elderly. Only studies classified by their authors as a systematic review, studies that addressed therapy for orofacial disorders in individuals over 18 years of age were included. The procedures performed included: electronic and manual search; selection of studies; data extraction; evaluation of the quality of studies and data analysis. It was possible to observe different types of interventions mainly aimed at the swallowing function, ranging from traditional therapy to the use of devices. However, due to the limitations of the studies, the data must be interpreted with caution.

Características miofuncionais orofaciais em adultos com disfunção temporomandibular crônica / Orofacial myofunctional characteristics in adults with chronic temporomandibular disorder

Objetivo: avaliar a condição miofuncional orofacial de indivíduos com disfunção temporomandibular, caracterizar o padrão de mastigação e investigar a relação entre a condição miofuncional orofacial e o desempenho nas funções de mastigação e deglutição. Materiais e métodos: foram analisados prontuários de participantes de um projeto de extensão interdisciplinar de odontologia e fonoaudiologia. A idade mínima para compor a amostra foi 18 anos. Os participantes haviam realizado exame odontológico e avaliação fonoaudiológica, com o protocolo de Avaliação Miofuncional Orofacial com Escores. Os resultados foram apresentados por distribuição absoluta,relativa e medidas de tendência central.Foram aplicados o teste t-student para amostras independentes e correlação de Pearson para avaliar associação. O nível de significância adotado foi 5%. As análises foram realizadas no IBM SPSS Statistics 21. Resultados: Dezessete prontuários integraram a amostra. A média de idade dos participantes foi 41,2 anos (±12,2),76,5% eram do sexo feminino. A média do escore total (AMIOFE) indicou condição miofuncional normal (92,5±5,14), porém da mastigação (7,94±1,60) e deglutição (13,1±1,17) revelam prejuízos funcionais. Não houve diferença significativa entre homens e mulheres no escore total (p=0,687), tampouco nas diferentes categorias avaliadas. Discussão:Os escores totais encontrados neste estudo, na mastigação e deglutição, estão de acordo com outras pesquisas realizadas e revelam alteração na função. Conclusão: as alterações funcionais orofaciais encontradas nos indivíduos com disfunção temporomandibular crônica deste estudo estão relacionadas com a condição miofuncional orofacial de uma maneira geral, e devem ser consideradas na elaboração de planos de tratamento, com o objetivo de proporcionar maior estabilidade aos resultados.

Aim: to evaluate the orofacial myofunctional condition of individuals with temporomandibular disorders, to characterize the mastication pattern and to investigate the relationship between the orofacial myofunctional condition and performance in mastication and swallowing functions. Materials and methods: medical records of participants in an interdisciplinary extension project in dentistry and speech therapy were analyzed. The minimum age to compose the sample was 18 years old. The participants had undergone a dental examination and speech-language pathology assessment, using the Orofacial Myofunctional Evaluation Protocol With Score protocol. Results were presented by absolute and relative distribution and measures of central tendency. Student's t-test for independent samples and Pearson's correlation were applied to assess association. The significance level adopted was 5%. Analyzes were performed using IBM SPSS Statistics 21. Results: seventeen medical records were part of the sample. The participants' mean age was 41.2 years (±12.2), 76.5% were female. The mean total score (OMES) indicated normal myofunctional condition (92.5±5.14), but mastication (7.94±1.60) and swallowing (13.1±1.17) revealed functional impairments. There was no significant difference between men and women in the total score (p=0.687), nor in the different categories evaluated. Discussion: The total scores found in this study, in mastication and swallowing, are in agreement with other studies carried out and reveal changes in function. Conclusion: functional variations found in subjects with chronic temporomandibular joint dysfunction in this study are related to general myofunctional orofacial disorder, and must be taken into consideration in treatment plans, with the aim of granting stability to the results.

Mastication in overweight and obese children: A comparative cross-sectional study

Abstract Objective: The objective of this study was to analyze masticatory characteristics in children from 7 to 10 years, and to compare these characteristics among normal weight, overweight and obese children. Methods: This is a cross-sectional study, conducted in northeast Brazil, with a sample of 160 children, aged 7 to 10 years. The authors evaluated: nutritional and dental status; food intake; masticatory parameters and orofacial myofunctional characteristics. The children were divided according to nutritional status into normal weight (n = 101), overweight (n = 33) and obesity (n = 26) groups. Results: The results showed that Obese children had a larger bite size (g) (median = 6.0, Q1-Q3 = 4.0-9.0, p = 0.049) and performed fewer masticatory sequences (median = 3.0, Q1-Q3 = 2.0-3.2, p = 0.024) than children with normal weight (median = 5.0, Q1-Q3 = 4.0-7.0; median = 4.0, Q1-Q3 = 3.0-5.0). Furthermore, obese children finished feeding in a shorter time (s) (median = 62.5, Q1-Q3 = 50.5-70.0, p = 0.039) than normal weight children (median = 66.0, Q1-Q3 = 56.5-78.0) and overweight children (median = 66.0, Q1-Q3 = 58.0-81.5). Conclusions: The present results suggest that obese children present changes in mastication, evidenced by larger bite-size, performing fewer masticatory sequences and rapid mastication, which may contribute to increased food consumption and the development of excess weight.

Effects of chewing gum on mask contamination

Aims@#The aim of this study was to evaluate whether chewing gum affects mask contamination.@*Methodology and results@#Two groups of participants were requested to wear a mask for 15 min with (experimental group) or without (control group) chewing gum. Then, masks were collected and CFU calculation and 16S rDNA sequencing was performed. We found that temperature, humidity and bacterial CFU inside of the mask significantly increased when wearing a mask while chewing gum. Staphylococcus epidermidis was found in both groups. Staphylococcus aureus, Staphylococcus haemolyticus, Streptococcus oralis, Streptococcus parasanguinis and Bacillus wiedmannii were found in only the experimental group.@*Conclusion, significance and impact of study@#Chewing gum significantly increased the temperature, humidity and bacterial CFU inside the mask. Staphylococcus epidermidis, S. aureus, S. haemolyticus, S. oralis, S. parasanguinis and B. wiedmannii were detected inside the mask after chewing gum.

Removable dentures and electrical activity of masticatory muscles in individuals with Parkinson's disease

ABSTRACT Purpose: to assess the influence of dentures on the electromyographic activity of masticatory muscles in individuals with Parkinson's disease. Methods: an analytical, quantitative, cross-sectional study conducted at a public teaching hospital in 2017, assessing the stage of the disease, non-denture (ND) wearing, upper removable partial denture wearing (DW1), upper and lower removable partial denture wearing (DW2), and upper complete denture + lower removable partial denture wearing (DW3). The Student-Newman-Keuls test was used to compare the maximum voluntary muscle contraction between sides and between the denture wearing and non-denture wearing groups. Significance was set at α<0.05. Results: after applying the eligibility criteria, 41 patient records were included in the sample. The association between the stage of the disease and denture wearing showed predominance of DW2 in stage 1 (43%). A significant difference was found in the masseter muscle analysis between the non-denture wearing group and DW2 and DW3 (p=0.0018). As for the anterior temporalis muscle, there was a significant difference (p=0.0034) in three of the analysis groups (ND vs. DW2, ND vs. DW3, and DW1 vs. DW3). Conclusion: denture wearing has a negative impact on the electrical activity of masticatory muscles when compared with individuals who do not wear dentures and have natural teeth.

Normalization of the electromyographic signals of masticatory muscles during non-habitual chewing activity

There is no consensus on the most appropriate method for normalizing electromyography (EMG) signals from masticatory muscles during isotonic activity. Aim: To analyze the best method for data processing of the EMG signal of the masticatory muscles during isotonic activity (non-habitual chewing), comparing raw data and different types of normalization. Methods: This is a cross-sectional study. Women aged between 18 and 45 years were selected. Anthropometric data were collected (age, height, body mass index ­ BMI, masticatory preference) as well as EMG signal (root mean square ­ RMS) data for the anterior temporal and masseter bilaterally, and for the suprahyoid muscles, during isotonic (non-habitual chewing) and isometric tasks. EMG data were processed offline using Matlab® Software. The normalization of the EMG signal was carried out using the 2nd masticatory cycle, chosen at random, of the 20 cycles collected, the maximum RMS value, and the maximum voluntary contraction (MVC). To analyze the best method of data processing for the isotonic data, the coefficient of variation (CV) was calculated. Descriptive data analysis was adopted, using the mean and standard deviation. ANOVA with repeated measures was used to detect significant differences between the methods of normalization. Statistical significance was set at 5% (α<0.05). Results: The final sample of this research was composed of 86 women. The volunteers presented an average age of 27.83±7.71 years and a mean BMI of 22.85±1.91 Kg/m2. Regarding masticatory preference, 73.25% reported the right side, and 26.75% the left side. Considering the comparison between the methods, the %CV measure of the 2nd cycle showed the lowest variation coefficient during biting for all the muscles from the raw data, RMS Max, and MVC (p=0.001, p=0.003, and p=0.001 respectively). Conclusion: In conclusion, for non-habitual chewing activity, the results of this study recommend data processing using normalization with the second cycle during chewing

Effect of frozen storage on preservation of a silicone-based test food material

Aim: This study aimed to evaluate the effect of frozen storage on the physical properties of a silicone-based test food material, highly used to evaluate the masticatory performance in research settings. Methods: A total of 1,666 silicone cubes of Optosil Comfort® with 5.6-mm edges were shaped and stored at -18°C. The cubes were subsequently tested for flexural strength (maximum force, displacement, stress, and strain) before breaking (n = 136), changes in weight and size (n = 170), and masticatory performance (n = 1360) at eight timepoints: immediately after cube preparation (baseline, no freezing), and 1, 2, 3 and 4 weeks, and 2, 4 and 6 months after frozen storage. The cubes were thawed 8 h before each assessment. Results: The maximum force, stress, maximum displacement, and deformation values for the cubes were not affected by freezing (P > 0.05). At all of the time points, the cubes exhibited similar weight (P = 0.366) and size (identical values). The masticatory performance for the cubes also showed no differences from baseline through 6 months (P = 0.061). Conclusion: Freezing Optosil Comfort® silicone cubes did not alter the physical and mechanical properties of the material, being suitable to optimize the assessment of masticatory parameters for research purposes

Masticatory function according to body mass index: part II: electromyographic analysis / Función masticatoria según índice de masa corporal: parte II: análisis electromiográfico

Introduction: The objective of this study was to explore the electrical activity of the superficial muscles of mastication required to exert unilateral maximum bite force in subjects with different body mass index. Material and Methods: A cross-sectional observational study was conducted with a sample of 21 participants with an average age of 22.9 ± 3.5 years who were classified according to their body mass index, forming three study groups: normal weight (18.5-24.9), overweight (25-29.9) and obesity (≥30), with seven participants each. Through surface electromyography, the superficial muscles of mastication during right and left maximum bite force were evaluated. Results: No statistically significant differences in the maximum bite force were observed between the study groups. The data obtained from the electromyographic analysis of the superficial muscles of mastication demonstrate a trend indicating that subjects with a normal body mass index similarly activate the muscles on each side when performing a maximum bite force on a particular side, while overweight or obese subjects demonstrated significantly greater activation of the temporalis muscle associated with the side where the maximal bite force is performed. Conclusion: Our findings suggest that the maximum bite force is not influenced by body mass index and that during the performance of a maximum bite force subjects with increased body mass index present a greater activation of the temporalis muscle associated with the side where the maximum bite force was performed.

Introducción: El objetivo de este estudio fue explorar la actividad eléctrica de los músculos superficiales de la masticación, necesarios para ejercer la máxima fuerza de mordida unilateral, en sujetos con diferente índice de masa corporal. Material y Métodos: Se realizó un estudio observacional de corte transversal con una muestra de 21 participantes con una edad promedio de 22.9 ± 3.5 años, quienes fueron clasificados de acuerdo a su índice de masa corporal, formando tres grupos de estudio: peso normal (18,5-24,9), sobrepeso (25,0-29,9) y obesidad (≥30.0), con siete participantes cada uno. La electromiografía de superficie evaluó los músculos superficiales de la masticación durante la fuerza de mordida máxima derecha e izquierda. Resultados: No se observaron diferencias estadísticamente significativas en la fuerza de mordida máxima entre los grupos de estudio. Los datos obtenidos del análisis electromiográfico de los músculos superficiales de la masticación demuestran una tendencia que indica que los sujetos con un índice de masa corporal normal activan de manera similar los músculos de cada lado cuando ejercen la fuerza de mordida máxima en un lado en particular. mientras que los sujetos con sobrepeso u obesos demostraron una activación significativamente mayor del músculo temporal asociado con el lado donde se realiza la fuerza máxima de mordida. Conclusión: Nuestros hallazgos sugieren que la fuerza de mordida máxima no está influenciada por el índice de masa corporal y que durante la realización de una fuerza de mordida máxima los sujetos con índice de masa corporal aumentado presentan una mayor activación del músculo temporal asociado al lado donde se realizó la fuerza de mordida máxima.

Masticatory function according to body mass index: part I: kinematic analysis using different food textures / Función masticatoria según índice de masa corporal: parte I: análisis cinemático utilizando diferentes texturas de alimentos

Introduction: Chewing is a learned orofacial function, important in the nutrition process of most mammals. It has been described that it can vary according to the characteristics of the individuals and the characteristics of the food. The aim of this study was to compare the kinematic characteristics of mastication in subjects with different body mass index (BMI), including foods of different hardness in the analysis. Material and Methods: A cross-sectional observational study was conducted. The mastication of 3.7 g of peanut (soft food) and 3.7 g of carrot (hard food) was compared among three study groups formed according to BMI: normal weight (BMI 18.5-24.9), overweight (BMI 25-29.9) and obese (BMI ≥30); each with 7 participants. The kinematics of the masticatory movement were assessed with a 3D Electromagnetic Articulograph, the characteristics analyzed were number of masticatory cycles, masticatory frequency, speed and area of the cycles. Results: No significant differences were noted among the study groups for the number of masticatory cycles, frequency or speed in the two foods studied. It was observed that when chewing carrot, the horizontal area of the masticatory cycles was significantly larger in the obese than in the overweight group. However, when chewing peanuts, this parameter did not present significant differences among the different groups. A comparison of the characteristics of mastication of the two foods revealed that the carrot chewing presented a significantly greater masticatory frequency and speed than the peanut chewing. Conclusion: This study demonstrated that food hardness influences the kinematic characteristics of mastication more than BMI, noting that hard foods are masticated faster and more frequently than soft foods and that masticatory frequency tends to increase with BMI.

Introduction: Chewing is a learned orofacial function, important in the nutrition process of most mammals. It has been described that it can vary according to the characteristics of the individuals and the characteristics of the food. The aim of this study was to compare the kinematic cha-racteristics of mastication in subjects with different body mass index (BMI), including foods of different hardness in the analysis. Material and Methods: A cross-sectional observational study was con- ducted. The mastication of 3.7 g of peanut (soft food) and 3.7 g of carrot (hard food) was compared among three study groups formed according to BMI: normal weight (BMI 18.5-24.9), overweight (BMI 25-29.9) and obese (BMI ?30); each with 7 participants. The kinematics of the masticatory movement were assessed with a 3D Electromagnetic Articulograph, the characteristics analyzed were number of masticatory cycles, masticatory frequency, speed and area of the cycles. Results: No significant differences were noted among the study groups for the number of masticatory cycles, frequency or speed in the two foods studied. It was observed that when chewing carrot, the horizontal area of the masticatory cycles was significantly larger in the obese than in the overweight group. However, when chewing peanuts, this parameter did not present significant differences among the different groups. A comparison of the characteristics of mastication of the two foods revealed that the carrot chewing presented a significantly greater masticatory frequency and speed than the peanut chewing. Conclusion: This study demonstrated that food hardness influences the kinematic characteristics of mastication more than BMI, noting that hard foods are masticated faster and more frequently than soft foods and that masticatory frequency tends to increase with BMI.

Effects of different degrees of root canal filling therapy on pain severity, stress response and masticatory function in patients with dental diseases / 中国基层医药

Objective:To investigate the effects of different degrees of root canal filling therapy on pain severity, stress response and masticatory function in patients with dental diseases.Methods:A total of 120 patients with dental disease who received treatment in Department of Oral Surgery, Zhoushan Hospital between December 2019 and December 2020 were included in this study. They were randomly divided into study and control groups ( n = 60/group). Patients in the control group were given excessive root canal filling and those in the study group were given approximate root canal filling. Cortisol, adrenocorticotropic hormone, interleukin-1β and interleukin-10 levels, bite force, gingival index and masticatory efficiency were determined before and after treatment. Visual Analog Scale (VAS) was used to evaluate the severity of pain in each group. Clinical efficacy was compared between the two groups. Results:After treatment, interleukin-1β, cortisol and adrenocorticotropic hormone levels in the study group were (23.66 ± 6.94) μg/L, (129.61 ± 27.18) μg/L, (14.58 ± 4.11) ng/L, respectively, which were significantly lower than those in the control group [(31.31 ± 10.13) μg/L, (147.93 ± 30.26) μg/L, (17.16 ± 5.04) ng/L, t = 4.82, 3.45, 3.07, all P < 0.05]. Interleukin-10 level in the study group was significantly higher than that in the control group [(65.19 ± 16.06) ng/L vs. (56.61 ± 15.52) ng/L, t = 2.97, P < 0.05). Bite force and masticatory efficiency in the study group were (127.53 ± 33.20) 1bs and (84.73 ± 20.65)%, respectively, which were significantly higher than those in the control group [(115.25 ± 30.12) 1bs, (75.49 ± 18.14)%, t = 2.12, 2.60, both P < 0.05]. Gingival index and Visual Analog Scale score in the study group were (0.44 ± 0.12) and (2.73 ± 0.81) points, respectively, which were significantly lower than those in the control group [(0.44 ± 0.12), (2.73 ± 0.81) points, t = 7.92, 2.66, both P < 0.05]. Total response rate in the study group was significantly higher than that in the control group (96.67% vs. 81.67%, χ2 = 5.52, P < 0.05). Conclusion:Appropriate root canal filling therapy is highly effect on dental diseases. It can decrease stress response, inhibit inflammation, alleviate pain, and improve masticatory function.

Mastication efficiency among stroke survivors with dysphagia / 中华物理医学与康复杂志

Objective:To compare the effect of age and gender on mastication efficiency between healthy volunteers and dysphagic stroke survivors and to document any correlation of mastication efficiency with mandible movements.Methods:Thirty-two stroke survivors with dysphagia and 84 healthy volunteers were asked to chew two-color gum. Their chewing efficiency was indicated by the degree of color mixing after chewing (SDHue). The SDHue value was evaluated using ViewGum software. The healthy volunteers were further divided into an age 20-40 years group, a 41-60 years group and an over-60 group. The SDHue values were compared among the 3 groups. The SDHue values were correlated with clinical mandibule movement scores.Results:Among the healthy volunteers, those older than 60 years had significantly higher SDHue values on average than those between 20 and 40 years. However, no significant gender difference was observed. The dysphagic stroke survivors had, on average, significantly higher SDHue results than the healthy volunteers, and those results were positively correlated with their mandible movement scores.Conclusions:Mastication efficiency tends to be age-related but not gender-related. Among those with post-stroke dysphagia mandible movement is positively correlated with mastication efficiency.

Therapeutic effects of finger pressing on Hegu acupoint on nausea in first-time complete denture wearers / 中国基层医药

Objective:To investigate the therapeutic effects of finger pressing on Hegu acupoint on nausea and to find an optimal method to reduce nausea in first-time complete denture wearers. Methods:Forty-one first-time complete denture wearers who received treatment between June 2016 and December 2019 in Huxi Hospital Affiliated to Jining Medical University were included in this study. They were randomly divided into observation group ( n = 21) and control group ( n = 20). The observation group received finger pressing on Hegu acupoint for 3 minutes before complete denture wearing and before three meals. The control group received self-adaptive therapy. After 3, 7 and 14 days of wearing complete denture, the number of wearers without nausea, the number of wearers with normal swallowing function, and the number of wearers with masticatory efficiency were recorded in each group. Efficacy was compared between two groups. Results:After 3 and 7 days of wearing complete denture, the percentage of complete denture wearers without nausea was 85.71% (18/21) and 95.24% (20/21), respectively, which were significantly higher than those in the control group [45.00% (9/20), 65.00% (13/20), χ2 = 5.58, 4.19, both P < 0.05 ]. After 14 days of wearing complete denture, there was no significant difference in number of wearers without nausea between observation and control groups ( P > 0.05). After 3 days of wearing complete denture, there was significant difference in percentage of wearers with normal swallowing function among total number of complete denture wearers between observation and control groups [57.14% (12/21) vs. 15.00% (3/20), χ2 = 8.16, P < 0.01). After 7 and 14 days of wearing complete denture, there was no significant difference in percentage of wearers with normal swallowing function among total number of complete denture wearers between observation and control groups (both P > 0.05). After 3 and 7 days of wearing complete denture, masticatory efficiency in the observation group was (42.03 ± 5.02)% and (50.34 ± 5.05)%, which were significantly higher than those in the control group [(37.00 ± 4.00)%, (47.13 ± 4.03)%, t = 3.51, 1.65, both P < 0.05]. After 14 days of wearing complete denture, there was no significant difference in masticatory efficiency between the two groups ( P > 0.05). Conclusion:Finger pressing on Hegu acupoint has good clinical effects on alleviating nausea in complete denture wearers and can shorten the adjustment time to first time wearing complete denture.

Combined association of oral and skeletal muscle health with type 2 diabetes mellitus among community-dwelling older adults in Japan: a cross-sectional study / Journal of Rural Medicine

Objective: Although oral health and skeletal muscle status are known to be risk factors for type 2 diabetes mellitus (T2DM), there is limited information on their combined effects among community-dwelling older adults. The purpose of this study was to investigate the association between oral health and skeletal muscle status among older adults with T2DM in Japan.Participants and Methods: This cross-sectional study included data from individuals aged ≥60 years. T2DM was defined as a glycosylated hemoglobin A1c level ≥48 mmol/mol (≥6.5%) or the use of hypoglycemic agents. For oral health status, dental hygienists assessed the number of teeth (NT) and masticatory function (MF). Skeletal muscle status was assessed using skeletal muscle mass index (SMI) and handgrip strength (HGS). Logistic regression analysis examined T2DM in nine-category combinations of oral health status (each of the three categories in NT and MF) and skeletal status (each of the three categories in SMI and HGS).Results: T2DM was prevalent in 83 participants (16.4%) and was significantly associated with low NT and SMI (odds ratio [OR] = 5.93, 95% confidence interval [CI]: 1.37–25.73) and low MF and SMI (OR = 4.48, 95% CI: 1.23–16.35) compared to high NT and SMI and high MF and SMI, respectively.Conclusion: Our findings indicate that low muscle mass with tooth loss or masticatory dysfunction is associated with T2DM among community-dwelling older adults. This suggests that maintaining oral health and muscle mass may be an effective strategy for the prevention of T2DM.

Self-assessed masticatory function and frailty in Brazilian older adults: the FIBRA Study

ABSTRACT OBJETIVE To investigate the relationship between the masticatory function and the frailty of older people. METHODS Exploratory cross-sectional study using secondary data from the FIBRA Project on the frailty conditions of older people living in urban areas of six Brazilian municipalities, from 2008 to 2009. The population consisted of older adults aged 65 and over with no cognitive impairment. A single session identification questionnaire and the Mini-Mental State Examination (MMSE) were applied, followed by collecting sociodemographic data and data on the participants' self-assessment of masticatory function, general health, and oral health. RESULTS 2,341 older people (164 frail older adults), of whom 63.2% reported not having seen a dentist in the last year, and approximately 26% of them had three or more functional feeding problems. Older participants (OR = 2.88; 95%CI: 2.01-4.13), who are retired (OR = 2.31; 95%CI: 1.18-5.53), those who were depressed (OR = 2.31; 95%CI: 1.58-3.38), and those who self-assessed their general health as worse compared to others of the same age (OR = 3.91; 95%CI: 2.39-6.40) were at higher risk of frailty. Three or more problems related to the functional aspects of mastication were associated with a greater chance of frailty (OR = 2.06; 95%CI: 1.25-3.41). CONCLUSION This study found an association between masticatory function and a greater chance of frailty among the studied population.

Duration of mastication and oral phase of swallowing in the elderly with different dental conditions: a clinical analysis / Duração da mastigação e da fase oral da deglutição em idosos com diferentes condições dentárias: análise clínica

ABSTRACT Purpose: to measure the total time of mastication and oral phase of swallowing in healthy elderly people, considering different food consistency, the presence of natural teeth, and the type of prosthetic oral rehabilitation, as well to compare dental conditions and consistencies. Methods: a cross-sectional study with 57 healthy elderly people, aged between 60 and 82 years, divided into: dentate group (D) (n=15); and rehabilitated groups; PD: fixed or removable partial dentures in one or both arches (n=15); CRD: maxillary and mandibular complete removable dentures (n=15); ISCD: complete dentures - maxillary removable denture and mandibular implant-supported dentures (n=12). The duration time (seconds) of chewing and of the oral phase of swallowing was measured in the consistencies: solid (a roll slice), pudding (10 ml) and liquid (10 ml). Results: healthy dentate elderly subjects had the following intervals: liquid=1.07±0.35 s; pudding=3.48±1.76 s; and solid=27.88±7.11 s. Statistically significant differences were observed between the D and ISCD groups (p=0.0056) and between D and CRD (p=0.0056) for liquid. For all groups, there was a statistically significant increase between liquid and solid consistencies and between pasty and solid ones (p<0.001). Conclusions: the dentate elderly had shorter oral phase time of swallowing for liquids than the rehabilitated edentulous elderly, but not different from the elderly with partial dentures. Chewing and swallowing time for solid food was longer than that for the other consistencies, regardless of dental condition.

RESUMO Objetivo: mensurar o tempo total da mastigação e da fase oral da deglutição em idosos saudáveis, considerando diferentes consistências alimentares, a presença de dentes naturais e o tipo de reabilitação oral protética, bem como realizar comparação entre as condições dentárias e as consistências. Métodos: estudo transversal com 57 idosos saudáveis, entre 60 e 82 anos, distribuídos em grupo dentado (D) (n=15) e grupos reabilitados: próteses parciais fixas ou removíveis em uma ou ambas as arcadas (PP) (n=15); prótese total removível maxilar e mandibular (PTR) (n=15); prótese total - prótese removível superior e prótese implanto-suportada inferior (PTIS) (n=12). O tempo de duração (segundos) da mastigação e da fase oral da deglutição foi medido nas consistências: sólida (pão francês), pudim (10 ml) e líquida (10 ml). Resultados: idosos dentados saudáveis apresentaram os intervalos: líquido=1,07±0,35 s; pudim=3,48±1,76 s; e sólido=27,88±7,11 s. Foram observadas diferenças estatisticamente significativas entre os grupos D e PTIS (p=0,0056) e entre D e PTR (p=0,0056) para líquido. Para todos os grupos, houve aumento estatisticamente significante entre as consistências líquida e sólida e entre pastosa e sólida (p<0,001). Conclusões: idosos dentados apresentaram menor tempo de fase oral da deglutição para líquidos do que idosos edêntulos totais reabilitados, mas não diferente dos idosos com prótese parcial. O tempo de mastigação e deglutição do alimento sólido foi maior que o das demais consistências, independente da condição dentária.

Masticatory function in elderly compared to young adults / Função mastigatória em idosos comparada a adultos jovens

ABSTRACT Purpose To characterize the masticatory function of the elderly and to compare total amount of time, masticatory strokes and total mastication score among the elderly and young adults. Methods It is an observational, cross-sectional and analytical study. A total of 50 individuals participated, 25 elderly (mean age 66 years) and 25 young adults (mean age 22 years). The evaluation of mastication was performed by standardized filming of the usual mastication of a wheat flour biscuit. The masticatory type (alternated bilateral, simultaneous bilateral, preferential unilateral, chronic and anterior), masticatory score, total masticatory time and the total number of masticatory strokes were verified and compared between the elderly and young adults. Results The predominant masticatory pattern in the young adults was the alternated bilateral mastication (52%), while, in the elderly, the simultaneous bilateral mastication predominated (48%). The use of dental prostheses had a significant influence on the total mastication score; elderly presented greater masticatory time and greater amount of masticatory strokes; however, the total masticatory score was lower for this group. Conclusion The use of dental prosthesis has a significant influence on masticatory function. When compared to young adults, the elderly had a greater amount of time and masticatory strokes and a lower total mastication score.

RESUMO Objetivo Caracterizar a função mastigatória de idosos e comparar o total de tempo e golpes mastigatórios e o escore mastigatório total entre idosos e adultos jovens. Método Trata-se de um estudo observacional, transversal e analítico. Um total de 50 indivíduos participaram do estudo, 25 idosos (idade média de 66 anos) e 25 adultos jovens (idade média de 22 anos). A avaliação da função mastigatória foi realizada por meio da filmagem padronizada da mastigação habitual de um biscoito maisena. O tipo mastigatório (bilateral alternado, bilateral simultâneo, unilateral preferencial, crônica e anterior), o escore mastigatório, o total do tempo mastigatório e o número total de golpes mastigatórios foram verificados e comparados entre os idosos e os adultos jovens. Resultados O padrão mastigatório predominante nos adultos jovens foi a mastigação bilateral alternada (52%), enquanto que nos idosos predominou a mastigação bilateral simultânea (48%). O uso de prótese dentária apresentou influência significativa no escore total da mastigação; os idosos apresentaram maior tempo mastigatório e maior quantidade de golpes mastigatórios; contudo, o escore total da mastigação foi menor para este grupo. Conclusão O uso de prótese dentária apresenta influência significativa na função mastigatória. Quando comparados aos jovens, idosos apresentam maior quantidade de tempo e golpes mastigatórios e menor escore total da mastigação.

Estratégias para o treino da mastigação e deglutição em indivíduos com disfunção temporomandibular e dor orofacial: uma revisão de escopo / Strategies to train mastication and swallowing in individuals with temporomandibular disorder and orofacial pain: a scoping review

RESUMO Objetivo identificar e sintetizar evidências sobre estratégias utilizadas no treino da mastigação e deglutição em indivíduos com disfunção temporomandibular e dor orofacial. Estratégia de pesquisa revisão de escopo desenvolvida com consulta nas bases de dados MEDLINE, LILACS, BBO, IBECS, BINACIS, CUMED, SOF, DeCS, Index Psi, LIPECS e ColecionaSUS (via BVS), Scopus, CINAHL, Embase, Web of Science, Cochrane e na literatura cinzenta: Biblioteca Digital Brasileira de Teses e Dissertações (BDTD), OpenGrey e Google Acadêmico. Critérios de seleção estudos quantitativos ou qualitativos, sem limite temporal e sem restrição de idioma, que continham os seguintes descritores ou palavras-chave: Articulação Temporomandibular, Síndrome da Disfunção da Articulação Temporomandibular, Transtornos da Articulação Temporomandibular, Dor Facial, Mastigação, Deglutição, Terapêutica, Terapia Miofuncional e Fonoaudiologia. Na primeira etapa, dois revisores fizeram a triagem independente dos estudos, por meio da leitura dos títulos e resumos. Na segunda etapa, os revisores leram, independentemente, os documentos pré-selecionados na íntegra. Em caso de divergência, um terceiro pesquisador foi consultado. Resultados as 11 publicações incluídas foram publicadas entre 2000 e 2018. As estratégias mais utilizadas foram o treino da mastigação bilateral simultânea, seguido da mastigação bilateral alternada. Na deglutição, foi proposto aumento do tempo mastigatório para reduzir o alimento em partículas menores e lubrificar melhor o bolo alimentar e treinos com apoio superior de língua. Conclusão o treinamento funcional demonstrou efetividade na reabilitação dos pacientes, embora não siga uma padronização e não seja realizado de forma isolada. Os estudos encontrados apresentam baixo nível de evidência. Considera-se fundamental a realização de estudos mais abrangentes e padronizados, como ensaios clínicos randomizados.

ABSTRACT Purpose To identify and synthesize evidence on strategies used to train chewing and swallowing in individuals with temporomandibular disorder and orofacial pain. Research strategy Scoping review conducted by search in MEDLINE, LILACS, BBO, IBECS, BINACIS, CUMED, SOF, DeCS, Index Psi, LIPECS, and ColecionaSUS (via VHL), Scopus, CINAHL, Embase, Web of Science, Cochrane, and the grey literature: Brazilian Digital Theses and Dissertations Library (BDTD), OpenGrey, and Google Scholar. Selection criteria Quantitative or qualitative studies, with no restriction on time or language of publication, with the following descriptors or keywords: Temporomandibular Joint; Temporomandibular Joint Dysfunction Syndrome; Temporomandibular Joint Disorders; Facial Pain; chewing (Mastication); swallowing (Deglutition); Therapeutics; Myofunctional Therapy; Speech, Language and Hearing Sciences. In the first stage, two reviewers independently screened the studies by title and abstract reading. In the second stage, the reviewers independently read the preselected documents in full text. In case of divergences, a third researcher was consulted. Results The 11 documents included in the review were published between 2000 and 2018. The mostly used training strategies were simultaneous bilateral mastication/chewing, followed by alternating bilateral mastication. In swallowing, increased mastication time was proposed to break food into smaller bits and better lubricate the bolus; training with upper tongue support was also indicated. Conclusion Functional training proved to be effective in rehabilitation, although it was not standardized or performed alone. The studies had low levels of evidence. It is essential to conduct more encompassing and standardized studies, such as randomized clinical trials.

Fotobiomodulação com laser de baixa potência na função mastigatória e nos movimentos mandibulares em adultos com disfunção temporomandibular: revisão sistemática com metanálise / Effects of low-level laser photobiomodulation on the masticatory function and mandibular movements in adults with temporomandibular disorder: a systematic review with meta-analysis

RESUMO Objetivo Revisar os efeitos da Fotobiomodulação com Laser de Baixa Potência na função mastigatória e nos movimentos mandibulares, em adultos com Disfunção Temporomandibular. Estratégia de pesquisa Busca nas bases de dados PubMed, Web of Science, Scopus, Embase, Cochrane, Lilacs, Science Direct e Google Scholar, utilizando os descritores: "temporomandibular joint disorders", "low level light therapy", "low level laser therapy", "mastication" e "mandible". Critérios de seleção Ensaios clínicos randomizados envolvendo adultos com Disfunção Temporomandibular, que utilizaram laser de baixa potência e avaliaram a mastigação e os movimentos mandibulares. Análise dos dados Inicialmente realizou-se a leitura dos títulos e resumos de todos os estudos encontrados. Em seguida, apenas os estudos selecionados na primeira etapa foram lidos na íntegra e avaliados quanto à elegibilidade. Após a seleção, foram analisadas as características dos estudos incluídos, bem como a sua qualidade metodológica e da evidência. Na metanálise, a média da amplitude de abertura de boca foi considerada como medida de efeito da intervenção. Resultados Verificou-se que os dez artigos incluídos apresentaram resultados muito distintos entre si, principalmente com relação à amplitude de abertura de boca, sendo a mastigação avaliada em apenas um deles. A maioria dos estudos apresentou alto risco de viés, demonstrando uma baixa qualidade metodológica. Considerando os seis estudos incluídos na metanálise, foram identificados resultados significativamente superiores para a fotobiomodulação. Conclusão Devido à escassez na literatura, não há evidências suficientes para os efeitos da fotobiomodulação com laser de baixa potência na mastigação. Já nos movimentos mandibulares, notou-se que essa intervenção apresentou resultados significativos, principalmente para o desfecho de amplitude de abertura de boca.

ABSTRACT Purpose To review the effects of low-level laser photobiomodulation on masticatory function and mandibular movements in adults with temporomandibular disorder. Research strategies Search in PubMed, Web of Science, Scopus, EMBASE, Cochrane, LILACS, ScienceDirect, and Google Scholar, using the following descriptors: "temporomandibular joint disorders", "low-level light therapy", "low-level laser therapy", "mastication", and "mandible". Selection criteria Randomized clinical trials in adults with temporomandibular disorder, using low-level laser and assessing the mastication and mandibular movements. Data analysis Firstly, the titles and abstracts of all retrieved studies were read. Then, only the studies selected in the first stage were read in full and assessed regarding eligibility. After the selection, the characteristics, methodological quality, and quality of evidence of the studies included in the review were analyzed. In the meta-analysis, the mean amplitude of mouth opening was considered as a measure of intervention effect. Results The 10 articles included in the review had quite different results one from the other, especially regarding the amplitude of mouth opening, while the mastication was assessed in only one of them. Most studies had a high risk of bias, demonstrating a low methodological quality. Significantly higher results for photobiomodulation were identified in the six studies included in the meta-analysis. Conclusion Due to the scarcity in the literature, there is not enough evidence of the effects of low-level laser photobiomodulation on mastication. As for the mandibular movements, this intervention presented significant results, particularly in the amplitude of mouth opening.

Assessment of satisfaction of patients submitted to bichectomy / Avaliação da satisfação dos pacientes submetidos à bichectomia

Objective: The aim this research was assess the level of satisfaction of patients undergoing bichectomy and its repercussions. Material and Methods: A cross-sectional and qualitative study, under protocol number 20707519.5.0000.5207, was carried out by applying a questionnaire to patients undergoing bichectomy, which made it possible to assess complaints, degree of postoperative satisfaction, satisfaction of family members, time required to perceive results, complications and adverse effects, intensity of postoperative pain, and possibility of being submitted to a new intervention. Results: The sample consisted of 30 patients, among them, 82% sought surgery for aesthetic reasons. Regarding the degree of satisfaction, the majority (70%) were very satisfied, followed by 13.3% who were satisfied, 10% considered normal, 3.3% were dissatisfied and 3.3% very dissatisfied. Regarding the opinion of friends and family, the majority were very satisfied with the result. The adverse effects found were mild, no permanent injury happened, and the pain was mild in the most majority of the sample. Conclusion: Thus, the most majority of patients were satisfied with the results, as well as their family and friends. The results were more evident between the second and third months. No major or permanent damage was observed, suggesting that it is a safe technique when performed well.(AU)

Objetivo: Avaliar o nível de satisfação dos pacientes submetidos à bichectomia, bem como correlacionar os resultados com algumas características clínicas. Material e Métodos: Foi realizado um estudo transversal e qualitativo, sob protocolo número 20707519.5.0000.5207, através da aplicação de um questionário a pacientes submetidos à bichectomia, o qual foi possível avaliar as queixas, o grau de satisfação pós-operatório, a satisfação dos familiares, o tempo para percepção dos resultados, as complicações e efeitos adversos, intensidade da dor pós operatória, e a possibilidade de ser submetido a nova intervenção. Além disso, as características demográficas da amostra (como sexo e idade) também foi registrada na ficha de avaliação. Resultados: A amostra foi composta por 30 pacientes, e desses, 82% buscaram a cirurgia por motivos estéticos. Sobre o grau de satisfação, a maioria (70%) ficou muito satisfeitos, seguidos por 13,3% que ficaram satisfeitos, 10% consideraram normal, 3,3% insatisfeitos e 3,3% muito insatisfeitos. Sobre a opinião dos amigos e familiares, a maioria ficou muito satisfeitos com o resultado. Os efeitos adversos encontrados foram leves, nenhuma lesão permanente foi encontrada, e a dor foi discreta na grande maioria da amostra. Com base na possibilidade de submeter-se a uma nova cirurgia, 70% ficaram satisfeitos e não fariam novamente. Conclusão: A grande maioria dos pacientes demonstrou-se satisfeitos com os resultados, bem como seus familiares e amigos. Os resultados foram mais evidentes entre o segundo e terceiro mês. Não foi observado qualquer dano importante ou permanente, sugerindo ser uma técnica segura quando bem executada. (AU)