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- ItemAcesso aberto (Open Access)Adenotonsillectomy in facial growing patients: spontaneous dental effects(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2011-10-01) Pereira, Silvia Regina Amorim; Bakor, Silvia Fuerte [UNIFESP]; Weckx, Luc Louis Maurice [UNIFESP]; School of Pindamonhangaba Graduate Program in Orthodontics; Unicsul Department of Graduate Studies in Orthodontics; Universidade Federal de São Paulo (UNIFESP)Children with hypertrophic tonsils and adenoids may have adverse effects on dental occlusion, which tend to worsen during the growth period. Diagnosis and early treatment is essential. AIM: Prospective clinical study to compare the cephalometric measurements before and after adenotonsillectomy in mouth breathing patients. MATERIAL AND METHOD: We had 38 patients of both genders, aged between 7 and 11 years in our sample, broken down into: oral group, 18 patients with obstructive hypertrophy of pharyngeal tonsil and/or palate grade 3 or 4; control group, 20 patients with normal breathing. Angular and linear dental measurements were compared between the groups in a 14 months interval. We used the t Student and Wilcoxon tests for unpaired samples, at 5% significance, for statistical purposes. RESULTS: The sagittal position and axial angle of the lower incisors increased significantly in the group with oral breathing, the sagittal position of the upper incisors increased significantly in the oral group, which still had a significant increase in overbite. CONCLUSION: Adenotonsillectomy was very effective in improving some dental measurements, with benefits to growing patients preventing malocclusions from becoming difficult to treat or permanent.
- ItemSomente MetadadadosCaries prevalence, levels of mutans streptococci, and gingival and plaque indices in 3.0-to 5.0-year-old mouth breathing children(Karger, 2004-01-01) Nascimento, E.; Mayer, MPA; Pontes, P.; Pignatari, ACC; Weckx, LLM; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
- ItemAcesso aberto (Open Access)Correlações entre alterações de fala, respiração oral, dentição e oclusão(CEFAC Saúde e Educação, 2011-02-01) Martinelli, Roberta Lopes De Castro; Fornaro, Érica Fabiana; Oliveira, Charlene Janaina Milanello De; Ferreira, Liege Maria Di Bisceglie; Rehder, Maria Inês Beltrati Cornacchioni [UNIFESP]; Associação dos Fornecedores de Cana de Piracicaba; Associação de Pais e Amigos dos Excepcionais; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP)PURPOSE: to check the correlations among speech disorders and mouth breathing symptoms with the type of dentition and occlusion, using video recordings. METHODS: a retrospective study with 397 patients, by studying the shooting script - ROF. Types of speech disorders and mouth breathing symptoms were assessed by Orofacial Motricity Specialist Speech and Language Pathologists and compared with the occlusal types proposed by Angle and with the dentition parameters, both evaluated by an Orthodontist. For the statistical analysis we used the program SPSS (Statistical Package for Social Sciences), version 13.0. For analyzing Spearman correlation, all assessment data were matched and analyzed. The adopted significance level was 5%. RESULTS: Considering speech disorders and dentition and occlusion data, we noted parallelism between distortion and crossbite, imprecision and bone deviation of lower midline line, locking and overjet, locking and overbite, frontal lisp and Angle Class III malocclusion, frontal lisp and malocclusion, frontal lisp and open bite, frontal lisp and crossbite; and frontal lisp and lower midline deviation. We also noted correlated opposition between locking and openbite, locking and bone deviation of lower bone midline, frontal lisp and Angle Class II-1 malocclusion, frontal lisp and overjet; and frontal lisp and overbite. Considering mouth breathing symptoms and dentition and occlusion data, we noted a symptom of parallelism between the protrusion of lower lip and overjet, accumulation of saliva on the labial commissures and crossbite, accumulation of saliva on the labial commissures and lack of intra-oral room; Half-opened lips at rest and Angle Class II-1 malocclusion. Dark eye circle and Angle Class II-1 malocclusion, protrusion of lower lip and Class II-1 malocclusion; and shortened upper lip and overbite show correlated opposition. CONCLUSIONS: the anterior lisp is correlated to dentition disorders and Angle Class III malocclusion; dark eye circle, protrusion of lower lip and half-opened lips in rest are adaptations found in Angle Class II-1 malocclusion, not characterizing oral breathing in this group; the accumulation of saliva on the labial commisures was a symptom of mouth breathing that was correlated with the disorders in dentition.
- ItemAcesso aberto (Open Access)Desmineralização dentária de pacientes respiradores orais submetidos à expansão maxilar(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2010-12-01) Bakor, Silvia Fuerte [UNIFESP]; Pereira, Julio Cesar Mota [UNIFESP]; Frascino, Silvana [UNIFESP]; Ladalardo, Thereza Christinna Cellos Gonçalves Pinheiro [UNIFESP]; Pignatari, Shirley Shizue Nagata [UNIFESP]; Weckx, Luc Louis Maurice [UNIFESP]; FAPI Curso de Especialização em Ortodontia; Universidade Estadual de Feira de Santana Curso de Odontologia; Universidade Federal de São Paulo (UNIFESP); APCDMouth breathing may cause deformities on the dental arch and be a risk factor for caries and periodontal disease; fixed orthodontic appliances compound the problem. AIM: to evaluate mineralization of tooth enamel and the oral cariogenic microbiota of mouth breathers that are using maxillary expanders. MATERIAL AND METHOD: a prospective study of 20 mouth-breathing patients with maxillary atresia, aged from 09 to 13 years. Enamel mineralization was measured using a fluorescence technique, before installing the expander and after its removal. The cariogenic microbiota was evaluated by the No Caries®. The t test (p<0.05) was applied for the statistical analysis, and the oral microbiota was analyzed by incidence. RESULTS: there was a statistically significant difference in the enamel mineralization level after maxillary expansion; the mean value was 3.08. The colorimetric test showed that the caries development potential was reduced in 45%, increased in 15%, and unaltered in 40% after maxillary expander use. CONCLUSION: there was a statistically significant difference in enamel mineralization after maxillary expansion; this difference was within the clinically normal range; the cariogenic potential increased in a small number of patients during orthodontic treatment.
- ItemSomente MetadadadosEfeitos morfofuncionais da disjunção maxilar em respiradores orais(Universidade Federal de São Paulo (UNIFESP), 2014-02-26) Gregolin, Paula Rotoli [UNIFESP]; Testa, Jose Ricardo Gurgel Testa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: The mouth breathers usually present altered shape and orofacial function, such as maxillary atresia precursor of skeletal posterior crossbite, interfering in areas of occlusal contact and chewing. For the correction of this malocclusion, the Hyrax expander allows the disjunction of the maxilla, improving the maxillarymandibular relationship and breathing. Objective: Evaluate the effects of the maxillary disjunction on the facial structures and chewing of mouth breathing children and teenagers. Method: Thirty patients (ages 6-14 years) underwent the procedure using the maxillary Hyrax appliance and evaluated at the pre - disjunction (T0), postdisjunction (T1) and 4 years after maxillary disjunction (T2), with frontal view radiography to obtain the craniofacial measures through the Cef-X program and analysis of chewing videotaped using the Sony Vegas Pro10 ® program to check the chewing type and mandible movements during chewing. The findings were compared over the three times. Results: In the evaluation of the sample before to disjunction, 43.3 % showed alternating bilateral chewing (AB), 56.7 % preferential unilateral (PU) and 13.3% (PU) of these on the left side. It was found that the side of the crossbite before maxillary expansion is not associated to the masticatory preference side throughout the three periods. The percentage of rotational cycles is related with the chewing side when evaluated three months after maxillary expansion (p = 0.040) while during the other periods this did not occur. An increase in the percentage of rotational cycles at times T1 and T2 was observed. Regarding change of chewing side comparing the 3 periods we noticed that most children maintained the side of chewing, and the percentage of T0 to T1, 52.4%; T0 to T2 and 52.4% and T1 to T2 58.3%. Also during the three periods, the study of the relationship between cephalometric information and the prefered masticatory side showed that only the inclination of the occlusal plane is related to the chewing side after 4 years of rapid maxillary expansion (p = 0.006). Conclusion: The maxillary disjunction in mouth-breathing children and teenagers promoted a positive inference in facial structures and affected the chewing very little, it showed a tendency to equilibrium after maxillary expansion.
- ItemAcesso aberto (Open Access)Estudo da relação entre a respiração oral e o tipo facial(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2007-08-01) Bianchini, Ana Paula; Guedes, Zelita Caldeira Ferreira [UNIFESP]; Vieira, Marilena Manno [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Breathing is responsible for facial and cranial morphology development. AIM: investigate in order to see if there is any relationship between oral breathing and facial type. MATERIAL AND METHODS: 119 male and female teenagers, with ages ranging between 15 and 18 years. The sample was separated in two groups: A-50 teenage oral breathers, 28 males and 22 females; and group B- 69 teenage nasal breathers, 37 males and 32 females. The sample was collected at the Centro de Atendimento e Apoio ao Adolescente do Departamento de Pediatria da UNIFESP/ EPM. We evaluated breathing and facial measures. RESULTS: by means of anthropometric indexes we classified facial types and associated them with the person s breathing type, Hypereuriprosopic (Total=0; oral breathers 0%; nasal breathers 0%; Euriprosopic (Total=14; oral breathers 2.52%, nasal breathers 9.24%;Mesoprosope (Total=20; oral breathers 19.32%; nasal breathers 21.01%, Leptoprosopic (Total=37; oral breathers 14.29%; nasal breathers 16.81%; Hyperleptoprosopic (Total =48; oral breathers 5.89% nasal breathers 10.92%). The mesoprosopic facial type was found in 48 teenagers (40.33%) of whom 25 (21.01%) were oral breathers and 23 (19.32%) were nasal breathers. Conclusion: it was not possible to prove the existence of an association between oral breathing and facial type.
- ItemAcesso aberto (Open Access)Estudo das alterações craniofaciais e da importância da expansão rápida da maxila após adenotonsilectomia(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2012-04-01) Pereira, Silvia Regina Amorim; Weckx, Luc Louis Maurice [UNIFESP]; Ortolani, Cristina Lúcia Feijó; Bakor, Silvia Fuerte [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); UNIPObstructive hypertrophy of the tonsils and/or adenoids is associated with mouth breathing and can lead to facial imbalances. Adenotonsillectomy is not enough to treat the anatomic changes. Facial orthopedic techniques aid in morphological and functional recovery. This prospective longitudinal clinical study aimed to observe craniofacial changes after adenotonsillectomy and to verify the importance of linking rapid maxillary expansion to treatment. METHOD: Fifty-three children of both genders, aged 6 to 12 years, were allocated to: Group 1, 20 children with nasal breathing; and group 2, 33 children with obstructive hypertrophy of pharyngeal and/or palate undergoing adenotonsillectomy. After surgery, this group was subdivided into Group 2A, 16 patients not treated with rapid maxillary expansion; and Group 2B, 17 patients treated with maxillary rapid expansion. Frontal and lateral cephalometric measurements were made prior to surgery and after 14 months. Statistical analysis used the Kruskal-Wallis and Wilcoxon tests - significance level of 5%. RESULTS: Adenotonsillectomy balanced transversal, sagittal and vertical growth in both groups, and was more effective in the group undergoing combined treatment. CONCLUSIONS: Adenotonsillectomy improved the facial growth of children with obstructive hypertrophy, which was more evident when associated with rapid maxillary expansion.
- ItemSomente MetadadadosEvaluation of nasal capacity before and after rapid maxillary expansion(Ocean Side Publications Inc, 2008-01-01) Cappellette, Mario [UNIFESP]; Cruz, Oswaldo L. M. [UNIFESP]; Carlini, Daniela [UNIFESP]; Weckx, Luc L. [UNIFESP]; Pignatari, Shirley S. N. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background: This study analyzed the effects of orthodontic maxillary expansion on the nasal cavity dimensions measured by acoustic rhinometry.Methods: A prospective study was performed. Fifty patients (27 male and 23 female patients) who had maxillary hypoplasia in relation to the mandible were studied. Patients presented either deciduous or mixed dentition, with age ranging from 4 to 14 years old. Twenty patients (11 male and 9 female patients) between the ages of 4 and 11 years, who also had deciduous or mixed dentition but without maxillary hypoplasia, served as a control group. A modified Biederman appliance was used for similar to 20 days to achieve the maxillary expansion in the treatment group. Acoustic rhinometry, with measurements of the right and the left nasal cavity, was performed before starting the maxillary expansion (T1) and at its conclusion (T2). This procedure was conducted also at a comparable time interval in the control group.Results: the treated group showed a significant increase in the majority of the values of transversal areas and nasal volumes when compared with the nontreated group.Conclusion: in children with maxillary hypoplasia, rapid maxillary expansion can not only move the maxilla and alveolar arches laterally but it can also increase the size of the nasal cavities.
- ItemRestritoInfluence of respiratory biofeedback associated with a quiet breathing pattern on the pulmonary function and habits of functional mouth breathers(Univ Federal Sao Carlos, 2007-09-01) Barbiero, Eliane de Fáveri Franqui [UNIFESP]; Vanderlei, Luiz Carlos Marques; Nascimento, Patrícia Cesar; Costa, M. M.; Scalabrini Neto, Augusto; Universidade de São Paulo (USP); UNESP; Ctr Ensino Super Maringa; Universidade Federal de São Paulo (UNIFESP)Objective: To evaluate the effects of using respiratory biofeedback associated with a quiet breathing pattern, on chest circumference, pulmonary function, respiratory muscle strength and the following functional mouth-breathing habits: watching things with mouth open, sleeping with mouth open, dribbling on the pillow, difficulty in waking up, snoring and restlessness during sleep. Method: Twenty functional mouth-breathing children were evaluated. They underwent 15 sessions of respiratory biofeedback by means of the biofeedback pletsmovent (MICROHARD (R) V1.0), which provided biofeedback on thoracoabdominal movements. Chest circumference, spirometry and maximum static respiratory pressures were determined before and after the therapy. the adults responsible for these children were asked questions about the children's mouth-breathing habits. Student's t test for paired data and non-parametric tests were used to analyze the data. Results: the use of respiratory biofeedback in association with a quiet breathing pattern did not produce significant alterations in chest circumference or in forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), Tiffeneau index (TI) or maximal expiratory pressure (MEP). However, there was a significant difference in maximal inspiratory pressure (MIP) (-53.6 +/- 2.9 cmH(2)O vs. -65.0 +/- 6.0 cmH(2)O; p< 0.05) and there were significant changes in the evaluated habits. Conclusion: the results allow the conclusion that respiratory biofeedback associated with a quiet breathing pattern improves the inspiratory muscle strength and habits of functional mouth-breathers. It can therefore be used as a therapeutic method for such individuals.
- ItemAcesso aberto (Open Access)Mouth breathing children have cephalometric patterns similar to those of adult patients with obstructive sleep apnea syndrome(Academia Brasileira de Neurologia - ABNEURO, 2009-09-01) Juliano, Maria Ligia [UNIFESP]; Machado, Marco Antonio Cardoso [UNIFESP]; Carvalho, Luciane Bizari Coin de [UNIFESP]; Prado, Lucila Bizari Fernandes do [UNIFESP]; Prado, Gilmar Fernandes do [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To determine whether mouth breathing children present the same cephalometric patterns as patients with obstructive sleep apnea syndrome (OSAS). METHOD: Cephalometric variables were traced and measured on vertical lateral cephalometric radiographs. The cephalometric measurements of 52 mouth and 90 nose breathing children were compared with apneic patients. The children had not undergone adenoidectomy or tonsillectomy and had not had or were not receiving orthodontic or orthopedic treatment. RESULTS: Mouth breathing children showed same cephalometric pattern observed in patients with OSAS: a tendency to have a retruded mandible (p=0.05), along with greater inclination of the mandibular and occlusal planes (p<0.01) and a tendency to have greater inclination of the upper incisors (p=0.08). The nasopharyngeal and posterior airway spaces were greatly reduced in mouth breathing children, as observed in patients with apnea (p<0.01). CONCLUSION: Mouth breathing children present abnormal cephalometric parameters and their craniofacial morphology resembles that of patients with OSAS.
- ItemAcesso aberto (Open Access)Mouth breathing in children with learning disorders(Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2013-09-01) Fensterseifer, Giovana Serrao; Carpes, Oswaldo; Weckx, Luc Louis Maurice [UNIFESP]; Martha, Viviane Feller; Pontifical Catholic Univ Rio Grande do Sul PUCRS; Pontificia Univ Catolica Rio Grande do Sul; Universidade Federal de São Paulo (UNIFESP); Univ Fed Rio Grande do SulGiven the importance of studying the causes of learning disorders, we designed this case-control study to assess the nasal cavity volume, pharyngeal and palatine tonsils in children with and without learning disabilities.Method: A total of forty-eight children were enrolled in the study: twenty-four coming from the Center for Evaluation and Early Stimulation (CADEP), in which the criterion is the school failure of at least two consecutive years; and twenty-four students with normal learning - which made up the control group. the children were submitted to ENT examination (history, physical examination) and specific tests (acoustic rhinometry, cavum radiography).Results: the results showed that students with learning disabilities have a higher prevalence of pharyngeal tonsil hypertrophy: p < 0.001, and palatine tonsil hypertrophy: p < 0.001. the average volume of the nasal cavities showed no statistically significant association with learning difficulties (P = 0.75).Conclusion: Based on this study, we concluded that children with adenotonsillar hypertrophy have more learning difficulties when compared to children without such hypertrophy.
- ItemAcesso aberto (Open Access)Obstructive sleep apnea prevents the expected difference in craniofacial growth of boys and girls(Academia Brasileira de Neurologia - ABNEURO, 2013-01-01) Juliano, Maria Ligia [UNIFESP]; Machado, Marco Antonio Cardoso [UNIFESP]; Carvalho, Luciane Bizari Coin de [UNIFESP]; Santos, Gianni Mara Silva dos; Zancanella, Edilson; Prado, Lucila Bizari Fernandes do [UNIFESP]; Prado, Gilmar Fernandes do [UNIFESP]; Universidade Federal de Sào Paulo São Paulo Hospital Department of NeurologyOBJECTIVES: It was to compare cephalometric measures of mouth-breather boys and girls and with the cephalometric pattern observed in obstructive sleep apnea syndrome (OSAS) patients. METHODS: Craniofacial measurements of lateral cephalometric radiographs obtained from 144 children aged 7-14 years were compared between boys and girls, and both were compared to cephalometric pattern of OSAS patients. RESULTS: Mouth-breather boys and girls had no gender differences regarding to craniofacial morphology while nose-breather boys and girls showed those expected differences. Nose-breather boys presented a more retruded mandible and proinclined upper incisor when compared to nose-breather girls, but mouth-breather boys and girls had no differences. The measure NS.GoGn was the only variable with an interaction with gender and breathing. CONCLUSIONS: There were no cephalometric difference in mouth breather-boys and girls related to normal growth, suggesting that oral breathing make the same craniofacial morphology and both have craniofacial morphology close to that of OSAS patients.
- ItemAcesso aberto (Open Access)Ocorrência da síndrome da apneia obstrutiva do sono (SAOS) em crianças respiradoras orais(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2010-10-01) Izu, Suemy Cioffi [UNIFESP]; Itamoto, Caroline Harumi [UNIFESP]; Pradella-Hallinan, Márcia Lurdes de Cássia [UNIFESP]; Pizarro, Gilberto Ulson; Tufik, Sergio [UNIFESP]; Pignatari, Shirley Shizue Nagata [UNIFESP]; Fujita, Reginaldo Raimundo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)It is well known that mouth breathing is associated with adenotonsillar hypertrophy - which is the main cause of obstructive sleep apnea among children. Despite the importance of this matter, there are only a handful of studies showing the relationship between OSAS and mouth breathing. AIM: to determine the prevalence of obstructive sleep disorders in mouth breathing children and study its correlation with otorhinolaryngological findings. STUDY DESIGN: Retrospective cohort study. METHOD: Data analysis from 248 medical charts of mouth breathing children seen at the Pediatric Otolaryngologic Division of a large medical institution between the years of 2000 and 2006. All patients had nasofibroscopy and or Cavum radiographs and polysomnographic exams. According to the Apnea index, patients were classified as primary snorers (AI<1); and as OSAS (>1). RESULTS: From 248 patients included in the study, 144 (58%) were primary snorers and 104 (42%) had OSAS. The most prevalent otorhinolaryngological findings were adenotonsillar hypertrophy (n=152; 61.2%), tonsilar hypertrophy (n=17; 6.8%), adenoid hypertrophy (n=37; 14.9%), rhinitis (n=155; 62.5%) and secretory otitis (n=36; 14.5%). CONCLUSIONS: primary snoring and OSAS are frequent findings in mouth breathing children. The most frequent otorhinolaryngological disorder in children with OSAS is adenotonsillar hypertrophy with or without rhinitis.