scholarly journals Relationship between Oral Parafunctions and Signs and Symptoms of Craniomandibular Dysfunction in Children with Cleft Lip and Palate

2021 ◽  
Vol 22 (3) ◽  
pp. 173-178
Author(s):  
Fabiana Vitória Ananias Gonçalves ◽  
Luiz Evaristo Ricci Volpato ◽  
Amanda Alves de Oliveira ◽  
Maria Emília Oliveira Gomes ◽  
Andreza Maria Fábio Aranha
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Mouth Opening ◽  
Signs And Symptoms ◽  
Dental Occlusion ◽  
Bivariate Analysis ◽  
Ratio Test ◽  
Craniomandibular Dysfunction ◽  
Craniomandibular Disorder ◽  
Nail Biting

Abstract The aim of this study was to evaluate the association of oral parafunctions with the presence of signs and symptoms of craniomandibular disorder in children with cleft lip and palate (CLP). A cross-sectional study was  performed in which one hundred and eighty-eight children with CLP and absence of associated syndromes or malformations were investigated. During clinical examination, the presence of wear facets and dental occlusion were observed and palpation was performed in the temporomandibular joint region (TMJ) and orofacial musculature . The children and their guardians were interviewed regarding the presence of oral parafunctional habits (bruxism, the act of biting the lips and/or cheeks, nail biting, sucking of fingers and pacifiers) and signs and symptoms of craniomandibular dysfunction (headache, ear and/or neckache, tiredness or crack in the TMJ during mouth opening and chewing movements). The data were analyzed by means of absolute and relative frequency measurements, and bivariate analysis using Pearson’s chi-square test and likelihood ratio test were performed, considering the significance level of 5%. A higher prevalence of cleft lip and palate type (76.0%) and the presence of malocclusion (61.7%) was observed, highlighting the anterior crossbite (58.7%) and midline deviation (48.9%). There was a higher occurrence of teeth grinding (40.4%), onychophagy (28.7%) and biting lips and/or cheeks (28.7%). Onychophagia was associated with headache (p <0.05) and with pain or cracking during mouth opening (p <0.05). It was concluded that parafunctional oral habits may be associated with signs and symptoms of craniomandibular disorder in children with cleft lip and palate.Keywords: Craniomandibular Disorders. Nail Biting. Bruxism. Maxillofacial Abnormalities. Resumo O objetivo do estudo foi avaliar a associação de parafunções orais com sinais e sintomas da disfunção craniomandibular em crianças com fissuras labiopalatinas (FLP). Um estudo transversal foi realizado, no qual cento e oitenta e oito crianças com FLP e ausência de síndromes ou malformações associadas, foram investigadas. Durante exame clínico, a presença de facetas de desgaste e a oclusão dentária foram observadas e foi realizada a palpação na região da articulação temporomandibular (ATM) e musculatura orofacial. As crianças e seus responsáveis foram entrevistados com relação à presença de hábitos orais parafuncionais (bruxismo, ato de morder os lábios e/ou bochechas, onicofagia, sucção de dedos e de chupeta) e sinais e sintomas de disfunção craniomandibular (cefaléia, ouvido, dor, cansaço ou estalo na ATM durante movimentos de abertura bucal e de mastigação). Os dados foram analisados por meio de medidas de frequência absoluta e relativa e a análise bivariada foi realizada por meio dos testes do Qui-quadrado de Pearson (χ2) e a Razão de verossimilhança, considerando o nível de significância de 5%. Uma maior prevalência das fissuras envolvendo lábio e palato (76,0%) e presença de maloclusão (61,7%) foi observada, com destaque para mordida cruzada anterior (58,7%) e desvio de linha média (48,9%). Houve uma maior ocorrência do ato de ranger os dentes (40,4%), da onicofagia (28,7%) e do hábito de morder lábios e/ou bochechas (28,7%). A onicofagia foi associada à cefaléia (p<0,05) e à dor ou estalo durante abertura bucal (p<0,05). Conclui-se que hábitos orais parafuncionais podem estar associados a presença de sinais e sintomas da disfunção craniomandibular em crianças com FLP.Palavras-chave: Transtornos Craniomandibulares. Hábito de Roer Unhas. Bruxismo. Anormalidades Maxilofaciais.

scholarly journals Association between speech and dental occlusion changes in children with cleft lip and palate and time of primary plastic surgeries

Revista CEFAC ◽  
2021 ◽  
Vol 23 (4) ◽  
Author(s):  
Gabriela Ribeiro Schilling ◽  
Maria Cristina de Almeida Freitas Cardoso ◽  
Paulo Sérgio Gonçalves da Silva ◽  
Marcia Angélica Peter Maahs
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cross Sectional Study ◽  
Dental Occlusion ◽  
Chi Square ◽  
Cross Sectional ◽  
Significance Level ◽  
Exact Test ◽  
Chi Square Test ◽  
Incisive Foramen

ABSTRACT Purpose: to describe the changes in speech and dental occlusion in children with cleft lip and palate and verify their association with each other and with the time of primary plastic surgeries. Methods: a cross-sectional study with collected data on the subjects’ identification, age at the time of primary surgeries, and clinical assessment of speech and dental occlusion. The chi-square test, Fisher's exact test, and t-test were used to verify the associations between the variables at the 5% significance level (p < 0.05). Results: the sample comprised 11 children aged 6 to 10 years, most of whom were males, self-reported white, with trans-incisive foramen cleft, predominantly on the left side. The mean age at lip repair surgery was 6 months, and 13 months at palatoplasty. Among the main dental occlusion changes, posterior and anterior crossbite stood out. All the subjects presented changed speech, with a prevalence of cases with dentoalveolar and palatine deformities, followed by passive and active changes. Subjects with anterior crossbite tended to have undergone primary lip repair surgery at a mean of four months earlier than the subjects without anterior crossbite. Conclusions: the associations between speech and dental occlusion changes, and between these and the time of primary plastic surgeries were not statistically significant. Even though it is known that early lip repair surgery is ideal to favor oral functions and aesthetics, the results revealed a tendency towards anterior crossbite, in these subjects.

The dental occlusion in treated and non-treated cleft lip and palate

1979 ◽  
Vol 1 (3) ◽  
pp. 181-187 ◽  
Author(s):  
P. V. Ponitz ◽  
M. N. Spyropoulos
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Dental Occlusion

Early Two-Stage Palatoplasty Using Modified Furlow's Veloplasty

2010 ◽  
Vol 47 (1) ◽  
pp. 73-81 ◽  
Author(s):  
Nishio Juntaro ◽  
Yamanishi Tadashi ◽  
Hiroshi Kohara ◽  
Yoshiko Hirano ◽  
Michiyo Sako ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Protocol ◽  
Dental Occlusion ◽  
Central Incisor ◽  
Two Stage ◽  
Treatment Protocols ◽  
Normal Occlusion ◽  
New Treatment ◽  
Velopharyngeal Function

Objective To achieve sufficient velopharyngeal function and maxillary growth for patients with unilateral cleft lip and palate (UCLP), the authors have designed a new treatment protocol for palate closure involving early two-stage palatoplasty with modified Furlow veloplasty. Details of the surgical protocol and the outcomes of the dental occlusion of patients at 4 years of age are presented. Design and Setting This was an institutional retrospective study. Patients Seventy-two UCLP patients were divided into two groups based on their treatment protocols: patients treated using the early two-stage palatoplasty protocol (ETS group; n = 30) and patients treated using Wardill-Kilner push-back palatoplasty performed at 1 year of age (PB group; n = 42). Interventions The features of the ETS protocol are as follows: The soft palate is repaired at 12 months of age using a modified Furlow technique. The residual cleft in the hard palate is closed at 18 months of age. Lip repair is carried out at 3 months of age with a modified Millard technique for all subjects. Results The ETS group showed a significantly better occlusal condition than the PB group. The incidence of normal occlusion at the noncleft side central incisor was 7.1% in the PB group; whereas, it was 66.7% in the ETS group. Conclusion The results indicate that the early two-stage protocol is advantageous for UCLP children in attaining better dental occlusion at 4 years of age.

Cleft Palate and Congenital Synechiae Syndrome: A Case Report

2004 ◽  
Vol 41 (2) ◽  
pp. 206-207 ◽  
Author(s):  
Siun M. Murphy ◽  
Suzanne Rea ◽  
Eleanor McGovern ◽  
Paddy Fleming ◽  
David Orr
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Mouth Opening ◽  
Baby Girl ◽  
Early Management ◽  
Secondary Palate ◽  
Normal Feeding ◽  
Oral Development

Objective A 1-day-old baby girl with a cleft of the secondary palate and a soft tissue band connecting the upper and lower jaws and preventing mouth opening was referred to the cleft lip and palate team by her pediatrician. This case represents a further example of an interesting but rare anomaly known as congenital alveolar synechia syndrome that requires early management to allow normal feeding and oral development.

Craniomandibular disorder/dysfunction. Characteristics and disorders of the masticatory organ

2015 ◽  
Vol 156 (4) ◽  
pp. 122-134 ◽  
Author(s):  
Géza Kiss ◽  
Miklós Pácz ◽  
Péter Kiss
Keyword(s):  
Treatment Options ◽  
Functional Anatomy ◽  
Mouth Opening ◽  
Diagnostic Algorithm ◽  
Early Years ◽  
Human Organism ◽  
Craniomandibular Dysfunction ◽  
Craniomandibular Disorder ◽  
And Function ◽  
Masticatory Organ

The practising physician often meets patients with pain located in different parts of the face and facial skull, mouth opening restriction or other motion disorder of the mandible. It is not always easy to identify and explain the cause. It is not widely known among doctors that most of these problems are due to masticatory dysfunction. There is a special group of patients showing functional disorders and there are some others who present a variety of different symptoms and visit several doctors. The masticatory organ, a functional unit of the human organism has a definite and separate task and function. In the early years of life it is capable of adaptation, while later on it tends to compensation. The authors outline the functional anatomy of the masticatory organ and the characteristics of multicausal pathology, the dynamics of the process of the disease and their interdisciplinary aspects. They discuss the basic elements of craniomandibular dysfunction. Based on the diagnostic algorithm, they summarize treatment options for masticatory function disorders. They emphasize the importance that physicians should offer treatment, especially an irreversible treatment, without a diagnosis. It occurs very often that the causes are identified after the patients become symptom-free due to treatment. The aim of this report is to help the general practitioners, dentists, neurologists, ear-nose-throat specialists, rheumatologists or any other specialists in the everyday practice who have patients with different symptoms such as pain in the skull, acoustic phenomenon of the joint or craniomandibular dysfunction. Orv. Hetil., 2015, 156(4), 122–134.

Patients With Cleft Lip and Palate Associated With Intraoral Fibrous Bands: A Report of 3 Cases and Review of Literature

2019 ◽  
Vol 57 (3) ◽  
pp. 389-394
Author(s):  
Natthacha Vamvanij ◽  
Zung-Chung Chen ◽  
Lun-Jou Lo
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Mouth Opening ◽  
Main Concern ◽  
Review Of Literature ◽  
Feeding Problems ◽  
Review Of The Literature ◽  
Early Management ◽  
Clinical Presentations ◽  
Maxilla And Mandible

In rare instances, cleft lip and palate occur in association with synechia, intraoral fibrous bands connecting the maxilla and mandible. The main concern in synechia is a restricted mouth opening that leads to airway and feeding problems. This study reports our experience in the treatment of 3 cases and includes a review of the literature. Three patients with intraoral fibrous bands received treatment and follow-ups in our center. Division of the bands and reconstruction of the lip and palate were successfully performed. All reported cases in the literature were collected for a summary of clinical presentations and as references for management. Early management of the synechia improves the mouth opening and facilitates the treatment of associated anomalies.

scholarly journals Usefulness of Airway Scope for Intubation of Infants with Cleft Lip and Palate–Comparison with Macintosh Laryngoscope: A randomized controlled trial

2019 ◽  
Author(s):  
Yoko Okumura ◽  
Masahiro Okuda ◽  
Aiji Sato (Boku) ◽  
Naoko Tachi ◽  
Mayumi Hashimoto ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Controlled Trial ◽  
Macintosh Laryngoscope ◽  
Mouth Opening ◽  
Head Tilt ◽  
Intubation Time ◽  
Airway Scope ◽  
Airway Complications ◽  
Significant Difference

Abstract Background: Airway Scope (AWS) with its plastic blade does not require a head-tilt or separate laryngoscopy to guide intubations. Therefore, we hypothesized that its use would reduce the intubation time (IT) and the frequency of airway complication events when compared with the use of Macintosh Laryngoscope (ML) for infants with cleft lip and palate (CLP). Methods: The parents of all patients provided written consents; we enrolled 40 infants with CLP (ASA-PS 1). After inducing general anesthesia using sevoflurane and rocuronium, we performed orotracheal intubations using either AWS (n = 20) or ML (n = 20), randomly. We define the duration between manual manipulation using cross finger for maximum mouth opening and the first raising motion of the chest following intubation by artificial ventilation as “IT;” further, the measured IT as primary outcomes. Airway complications were considered secondary outcomes. Moreover, we looked for associations between IT and the patient’s characteristics: extensive clefts, age, height, and weight. We used the Mann–Whitney test and Fisher’s exact probability test for statistical analysis; p < 0.05 was considered as statistically significant. Results: The mean IT was 31.5 ± 8.3 s in AWS group and 26.4 ± 8.9 seconds in ML group. Statistical significant difference was not found in IT between the two groups. The IT of AWS group was statistically related to extensive clefts. Airway complications were detected in ML group. Conclusion: AWS is useful for intubation of infants with CLP; it required IT similar to that required using ML, with a lower rate of airway complications. Trial Registration UMIN-CTR Registration number UMIN000024763 Registered 8 November 2016 Keywords: Airway Scope, Macintosh Laryngoscope, infant, intubation time

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