Evaluation of oral functions of the stomatognathic system according to the levels of asthma severity / Avaliação das funções orofaciais do sistema estomatognático nos níveis de gravidade de asma

PURPOSE: To compare the orofacial functions (chewing, swallowing and speech) in children with asthma and healthy children. METHODS: A cross sectional study including 54 children of both genders with ages between 7 and 10 years was conducted. Twenty-seven of these subjects composed the experimental group, and were subdivided into two severity levels of asthma: Group I - mild intermittent and persistent asthma; Group II - persistent moderate to severe asthma. Twenty-seven healthy children were included in the control group (Group III). Speech-language pathology evaluation used the adapted Orofacial Myofunctional Assessment Protocol. Adaptation consisted in the exclusion of the structural part of the test, since this was not the aim of the study. The structural part was excluded because it was not the aim of this study. RESULTS: It was found alterations in oral functions, with significant differences between the three groups. These alterations showed no correlation with asthma severity, since the highest rate of alterations was found in Group I (mild asthma). CONCLUSION: Regardless of the severity level, children with asthma have altered patterns of chewing, swallowing and speech.

OBJETIVO: Avaliar as funções orofaciais de mastigação, deglutição e fala em crianças asmáticas e crianças saudáveis. MÉTODOS: Estudo de corte transversal com 54 crianças, com idades entre 7 e 10 anos completos, de ambos os gêneros. Do total, 27 compuseram o grupo experimental e foram subdivididas em dois níveis de gravidade de asma: Grupo I - asma intermitente ou persistente leve; Grupo II - asma persistente moderada ou grave. Fizeram parte do grupo controle (Grupo III) 27 crianças saudáveis. Para a avaliação fonoaudiológica foi utilizado o Protocolo de Avaliação Miofuncional Orofacial adaptado. A adaptação constituiu na exclusão da parte estrutural, já que esta não fazia parte do objetivo do estudo. RESULTADOS: Alterações nas funções orofaciais foram encontradas, com diferenças entre os três grupos estudados. Essas alterações não tiveram relação com a gravidade da asma, visto que o maior índice de alterações foi encontrado no Grupo I (asma leve). CONCLUSÃO: Independentemente do nível de gravidade da doença, crianças asmáticas apresentam padrões alterados de mastigação, deglutição e fala.

Anomalías dentó maxilares y factores asociados en niños con parálisis cerebral / Dento-maxillary analysis and related factors in children with cerebral palsy

Background: Patients with cerebral palsy attending the Children Rehabilitation Institute (Teleton) at Santiago-Chile present open bite and oral disfunctions. Objective: Determine dento-maxillary anomalies related to cerebral palsy and factors associated to feeding, breathing and parafunctional habits. Method: Descriptive study including 80 children of both sex, between 4-12 years-old, with cerebral palsy. A revisión of clinical files, extra and intraoral exams and a parents investigation was performed. Results: 83 percent of children have severe spastic tetraparesis. A high incidence of open bite incisors was found, long faces compatible with dolicofacial growing and labial incompetence. Associated to this facial biotype, mixed breathing with bucal predominance and absence of lateral movements were found in these children. The intermaxillary relation is type I and the Angle's classification is neutrón occlusion. In relation to feeding habits, 50 percent of patiens with tetraparesis eat their food cut in very small pieces, whereas 60 percent with diplegia and hemiparesia eat their food in a normal way. The parafunctional habits were significant (47 percent). Conclusions: Cerebral palsy is an important condition in the development of a dento-maxillary disarmony, like open bite and dysfunctional sthomatognatic system.

Introducción: Los pacientes con parálisis cerebral atendidos en el Instituto de Rehabilitación Infantil de Santiago, presentan mordidas abiertas y disfunción oral. Objetivos: Determinar anomalías dentó maxilares y relacionarlas con diagnóstico de parálisis cerebral y factores asociados de alimentación, respiración y hábitos parafuncionales. Pacientes y Método: Estudio descriptivo transversal, que incluyó revisión de fichas clínicas 2005-2006, examen extra e intraoral y encuesta a los padres de 80 niños, ambos sexos, con diagnóstico de parálisis cerebral entre 4 y 12 años de edad. Resultados: 83 por ciento de los niños, presentó tetraparesia espástica severa. Se encontró alta incidencia de mordida abierta anterior, caras alargadas compatibles con crecimiento dolicofacial e incompetencia labial. Asociado a este biotipo facial, se halló respiración mixta de predominio bucal y ausencia de movimientos de lateralidad. La relación intermaxilar es tipo I y neutro oclusión según clasificación de Angle. De los hábitos de alimentación, el 50 por ciento de los pacientes con tetraparesia comen picado; alrededor del 60 por ciento con diplejia y hemiparesia comen entero. Los hábitos parafuncionales no fueron significativos, 47 por ciento de los pacientes encuestados los tenían. Conclusiones: La parálisis cerebral es una variable importante asociada al desarrollo de una desarmonía dentomaxilar como la mordida abierta y de la disfunción del sistema estomatognático.