Physical Therapy as first therapy to mandibular fracture in a pediatric patient

Mandibular fractures are the most common in children, however with a low incidence because of child anatomy. Among the sites, the condyle is one the most fracture site, being a dilemma to surgeons about your management. The treatment to condyle fracture can be a surgical approach or conservative management. Conservative treatment presents the IMF, appliances, soft diet, and physiotherapy as an option, and these treatments can be applied isolated or associated. Physical Therapy has been a few reported in the literature as isolated therapy, reported as complementing the surgical approach, or after orthodontic/appliances therapy. Promote early mandibular mobility is important to restore function and prevent future complications such as ankylosis. Instruments to perform physiotherapy are expensive and not accessible to the entire population. Therefore, the present study presents a case of a pediatric patient with condyle fracture treated with a soft diet and physiotherapy with wooden spatula.

Oral Motor Treatment Efficacy: Feeding and Swallowing Skills in Children with Cerebral Palsy

This study is aimed at identifying the relationship between oral motor treatment and the improvement of abilities for feeding and swallowing in boys and girls with CP residing in the state of Yucatán. The sample consisted of 30 patients with a diagnosis of CP and the presence of ADT, with gross motor function levels from II to V, between 3 and 14 years old, of which 50% received oral motor treatment. The predominant diagnosis was spastic CP and tetraplegia. An interview was carried out with the tutor, the application of the gross motor skills scale, and an assessment of feeding skills. The feeding and swallowing skills that improved significantly with the oral motor treatment were mandibular mobility, tongue activity, abnormal reflexes, control of breathing, and general oral motor skills ( p ≤ 0.05 ). Within the sample that did not receive oral motor treatment, 46% presented low or very low weight and 40% referred recurrent respiratory diseases. In the end, it was concluded that feeding skills improve significantly with oral motor treatment, regardless of the severity of gross motor involvement. Likewise, oral motor treatment was associated with a lower presence of respiratory diseases and nutritional compromise.

Short-Term Effects of Intra-Articular Hyaluronic Acid Administration in Patients with Temporomandibular Joint Disorders

The study described in this paper was conducted to assess the short-term outcomes of intra-articular administration of hyaluronic acid in patients with symptoms of temporomandibular joint disorders. A group of 40 patients suffering from temporomandibular joint disorders underwent a series of hyaluronic acid intra-articular injections. Questionnaires and clinical examinations were conducted to assess stress exposure of the subjects and to evaluate short-term treatment outcomes, i.e., reducing joint and muscle pain and increasing the mobility of the mandible. A weak positive correlation between stress exposure and pain was observed. As a result of treatment, 61% of subjects revealed a total reduction of muscle pain, while joint pain completely resolved in 88% of patients. Mandibular mobility increased by 11%, 31%, 9%, and 11% regarding opening, protrusive, and lateral right and left movements, respectively. The study confirms the short-term effectiveness of intra-articular administration of hyaluronic acid on reducing joint and muscle pain in patients with articular disc displacement. The treatment positively affected the mobility of the mandible in all directions. The verification of late treatment effects of hyaluronic acid viscosupplementation requires the continuation of the research.

Prevalence of Temporomandibular Dysfunction and its Association with Malocclusion in Children: An Epidemiologic Study

Introduction: Malocclusion is one etiological factor of temporomandibular joint disorder (TMD). This study investigates the prevalence of TMD and the relationship between TMD and the type of occlusion. Study design: A sample of 923 children (463 girls and 460 boys, ages 7–12 years old) was grouped not only by chronological age but also by gender. The information was collected on functional occlusion (anterior and lateral sliding, interferences), dental wear, mandibular mobility (maximal opening, deflection, deviation), and temporomandibular joint and muscular pain recorded by palpation. Results: Headache was the only symptom of temporomandibular dysfunction (TMD) reported by the children. The results showed that one or more clinical signs were recorded in 25% of the subjects, most of which were mild in character. The prevalence increased during the developmental stages. Girls were in general more affected than boys. Conclusions: In this study, many subjects with TMD had malocclusions. Early treatment may be important in the prevention of severe TMD. Significant associations were found between different signs, and TMD was associated with posterior crossbite, anterior open bite, Angle Class II and III malocclusions, and extreme maxillary overjet.

Parafunctions, signs and symptoms of temporomandibular disorders (TMD) among adolescents 14 to 15 years of age

Introduction. Temporomandibular Joint Disorders (TMD) increasingly affect not only adults but also adolescents. Parafunctions are cited as the most common cause of TMD. Aim of the study. To determine the prevalence of oral parafunctions, signs and symptoms of TMD among adolescents. Methods. The study was performed as a part of an early detection of risk factors for civilization diseases program – SOPKARD1 in 96 children aged 14-15 years. Each participant filled in a questionnaire regarding their oral habits and symptoms of TMD and underwent physical examination of the muscles and temporomadibular joints. The analysis of the mandible mobility models was also made. Results. Leaning one’s chin on the hand (73.68%), lip biting (58.33%) and intensive gum chewing (51.04%) were the most common habits among the study group. Persistence of an infantile swallow pattern was observed in over one-fifth of patients (20.83%). The most common signs were teeth impressions on tongue and cheeks (53.13%), increased muscle tone (57.29%) and dysfunctions in mandibular mobility (53.13%). Most subjects (92.71%) manifested at least one sign or symptom, whereas 46.88% two or three. A statistically significant association was found between chewing gum and muscle response, as well as infantile swallow pattern and open bite and muscle response. Conclusions. Most adolescent aged 14-15 were subject to some parafunctional habits. There is a requirement to introduce an educational program in schools in order to present the destructive consequences of parafunctions on the stomatognathic system health and the possibility of prevention or treatment.