Lip Closure Research Articles

The effects of safinamide on dysphagia in Parkinson's disease.

Dysphagia is a potentially fatal symptom of Parkinson's disease (PD) and is characterized by frequent silent aspiration, a risk factor for aspiration pneumonia. The transdermal dopamine agonist rotigotine alleviates dysphagia in patients with PD and is more effective than oral levodopa, suggesting the importance of continuous dopaminergic stimulation (CDS) in swallowing. Safinamide is a monoamine oxidase B (MAOB) inhibitor that facilitates CDS. In this retrospective open-label evaluator-blinded research, swallowing functions in nine patients with PD were examined using a video fluoroscopic swallowing study (VFSS) before and after treatment with 50 mg of oral safinamide. The VFSS results showed that safinamide significantly improved some swallowing measures during oral and pharyngeal phases, including oral transit time and pharyngeal transit time, without worsening of any measures. Notably, improvements in lip closure, an oral phase component, seemed to be most attributable to improvements in oral phase scores. In conclusion, a medicine for CDS may effectively improve swallowing functions in patients with PD. This is the first study to show that the MAOB inhibitor safinamide partly but significantly improves swallowing function in patients with PD.

Nonsurgical Orthodontic Treatment in an Adult with Skeletal Class III Malocclusion Using Passive Self-ligating System: A Case Report

Skeletal Class III malocclusion treatment is complex, especially when jaw deviations are serious. Camouflage treatment of skeletal Class III malocclusion improves prognosis with a slight-to-moderate functional shift. This report presents the case of a 23-year-old male with poor facial esthetics associated with chin protrusion and an uncomfortable bite. He had a concave profile, unfavorable incisor displays, protrusive lower lip, and strained lip closure. Camouflage therapy with a passive self-ligating (PSL) system through the anterior teeth of the maxilla protraction and arch expansion was used. After 14 months of treatment, the overjet outcome was positive. The teeth were arched, asymmetry was addressed, the convex profile and no deviation occurred when the jaw was closed. Factors in using the PSL system were low friction between the bracket and archwire, torque selection, and the significant dental arch expansion ability. The PSL system is an appropriate option in treating adults with skeletal Class III malocclusion to achieve a normal occlusion and a pleasant facial profile.

Electromyographic signals and the starting threshold voltage of orbicularis oris muscle in healthy rhesus monkeys

Objective: To investigate the characteristics of electromyography (EMG) signals and the starting threshold voltages of the orbicularis oris muscles (OOM) in healthy rhesus monkeys under different muscle movement conditions. Methods: The EMG signals and the starting threshold voltages at different time points in 4 healthy rhesus monkeys were acquired and recorded with EMG device and evoked potentiometer. The voltage amplitude variation of EMG signals was analyzed, and the voltage amplitude range of EMG signals at the beginning of OOM contraction was established. The data were statistically analyzed by one-way ANOVA. Results: The EMG of OOM in healthy monkeys in the quiet, natural and continuous mouth-closed state was linear and relatively stable, and the absolute value fluctuated between 15 and 50 μV. The EMG waveform increased rapidly during the natural lip contraction movement, and its amplitude fluctuated greatly, with the highest absolute value of the peak value reaching hundreds of microvolts. The amplitude of EMG induced by continuous mouth closure was more than thousands of microvolts. There was no significant difference in EMG amplitudes of OOM in the healthy rhesus monkey under quiet and continuous lip closure at different time points (P>0.05). There was no significant difference in threshold voltages in the state of natural lip contraction of bilateral OOM at different time points (average range: 57.17-57.47 μV) in the healthy rhesus monkeys (P>0.05). There was no significant difference in threshold voltages of OOM induced by bilateral OOM at different time points(average range: 55.38-55.99 μV) in the healthy rhesus monkeys(P>0.05). There were significant differences in the absolute values of EMG amplitudes of OOM between the three lip movement modes: (30.67±8.72) μV in quiet and natural continuous lip closure (475.12±54.72) μV in natural lip contraction, and (921.22±312.79) μV in the induced persistent lip closure, with t values of -8.48, -9.35 and -5.01 respectively, all P<0.001. Conclusions: The EMG signals of OOM show different characteristics under different muscle movement conditions, which can be used as a basis for computer to judge and recognize the movement conditions of OOM. The upper limits of the EMG threshold voltage values of OOM under different motion states are 55-60 μV.

Surgical-Orthodontic Treatment of Class III Malocclusion with Anterior Open Bite

A 21-year-old female came with chief complaints of inability to incise food and poor esthetics. The patient presented with a concave facial profile, long face with a steep mandibular angle, incompetent lip closure, and acute nasolabial angle. Intraorally, she had negative 6 mm overjet, 3 mm open bite and dental crowding. She was diagnosed as severe skeletal Class III malocclusion and anterior open bite. The treatment plan included orthodontic treatment with orthognathic surgery and extraction of maxillary second molars, which were supra-erupted and tipped buccally. The pre-operative orthodontic alignment took 11 months. The surgical correction included maxillary Le Fort I osteotomy with 4 mm advancement, mandibular intraoral vertical ramus osteotomy with 6.5 mm setback and genioplasty. The total surgical-orthodontic treatment time was 16 months. The final result presented a straight profile with stable occlusion. The patient’s facial and dental esthetics, masticatory function, and quality of life were all significantly improved after surgical-orthodontic treatment.

Utilizing a Lip Closure Prompt to Increase Food Acceptance in the Treatment of Feeding Disorders

Utilizing a Lip Closure Prompt to Increase Food Acceptance in the Treatment of Feeding Disorders

Comparison of post-surgical soft tissue changes between bilateral cleft patients treated with and without a modified nasoalveolar molding appliance: A cohort study

The advantages of nasoalveolar molding (NAM) treatment for cleft lip and palate (CLP) patients have been well documented. A modified design for bilateral CLP was introduced. This paper aimed to: 1- quantify the soft tissue changes after applying modified NAM treatment to these patients; and 2-compare post-surgical changes to a control group where no NAM was used. At a tertiary care paediatric hospital, a historical cohort group of complete BCLP patients (n=15) was compared to a prospectively collected group of complete BCLP patients who underwent NAM therapy (n=15). In the NAM group (mean age: 1.1mos±0.2), a new modification of the NAM appliance was implemented. In the control group (mean age: 5mos±0.2), no NAM treatment was adopted prior to lip closure surgery. Soft tissue nasolabial segments were measured on initial (T1), post-NAM (T2) and 3 months post-surgery (T3) photographs; measurements were analysed statistically. In the NAM group, cleft size was reduced by 68 to 70% in 4-5months and all measurements improved between T1 and T2. Columellar crest inclination decreased by 74%, columellar length increased by 184%, nostril and bialar widths decreased by 36% and 16%, respectively. The lip philtrum was elongated by 49.5%. At T3, all soft tissue variables statistically improved better in NAM versus non-NAM groups. The modified NAM appliance provided improved results of lip approximation and nasal measurements compared to non-NAM treatment.

Alterations in deglutition in children with congenital Zika virus syndrome.

To characterize swallowing in children with congenital Zika virus syndrome in comparison to typical children. This cross-sectional study enrolled 45 children diagnosed with congenital Zika virus syndrome and 45 others with typical development. Swallowing was evaluated through clinical feeding evaluations Protocolo de Avaliação Clínica da Disfagia Pediátrica and using acoustic swallowing parameters (Doppler sonar). The mean age of children with congenital Zika virus syndrome was 26.69 ± 4.46 months and the mean head circumference was 29.20 ± 1.98 cm. Moderate/severe oropharyngeal dysphagia was found in 32(71.1%) of the children with congenital Zika virus syndrome. Significant differences were found between the groups on clinical evaluation: Children with congenital Zika virus syndrome presented insufficient lip closure 42(93.3%) and altered tonus of the tongue 35(77.8%) and cheeks 34(75.6%). In the children in the comparison group, only 6(13.3%) presented insufficient lip closure and 1(2.2%) had inadequate tongue posture. Changes during swallowing with liquid and spoonable food were not observed in the comparison group. When liquid/food was offered, affected children presented difficulties in sipping movements 14(77.8%) and lip/spoon contact 35(75%). The presence of residual food in the oral cavity after swallowing 38(86.4%) and clinical signs indicative of laryngotracheal penetration/aspiration, such as coughing, gagging and/or labored breathing, were also notable. No differences were found between the groups with regard to the acoustic parameters evaluated instrumentally. Children with congenital Zika virus syndrome present alterations in the oral phase of swallowing, as well as clinical signs indicative of pharyngeal phase impairment.

Terapia miofuncional orofacial associada ao uso da placa palatina de memória em crianças com Trissomia do 21: estudo de casos

ABSTRACT Individuals with trisomy 21 may have muscle hypotonia of the speech articulation organs, an enlarged protruding tongue positioned on the floor of the mouth, and a lack of lip closure. The stimulating palatal plate is an intraoral appliance that, associated with myofunctional therapy, aims to improve these children’s habitual lip and tongue posture. This study aimed to present the cases of four male children with trisomy 21, with a mean age of 6.7 and a standard deviation of 7.8 months, who used the stimulating palatal plate in association with myofunctional therapy. The children used the plate for 6 months and did exercises based on the orofacial regulation therapy, and their parents received instructions on feeding them and removing deleterious oral habits. In the first session and at the end of the treatment, each child’s face was video-recorded for 5 minutes at rest, and two researchers analyzed independently their habitual tongue and lip posture. Participants who began the treatment earlier and had the most severe postural changes had greater tongue and lip posture improvement.

The relationship between morphological changes and oral function before and after slow palate expansion

ABSTRACT Purpose Recent reports indicate that Japanese children have narrow dental arches with weakening oral functions. Therefore, this study investigated the relationship between palatal morphology and oral function after expansion treatment with a slow, removable expansion appliance. Materials and Methods We evaluated changes in the deep, middle, and shallow palatal widths of 22 children with narrow dental arches who visited our hospital. We also assessed the tongue raising force, maximum occlusal force, lip closure force, and masticatory movement patterns, representing the oral function. Changes in the hyoid and resting tongue position before and after treatment were also evaluated using lateral cephalometric radiographs. Finally, the patients were divided into two groups based on the expansion frequency (once every two weeks or once per week) for measurement comparisons. Results We found that the amount of expansion at the deep width of the palate was half that at the shallow width. Furthermore, the maximum occlusal force and tongue raising forces improved after the treatment. Additionally, multiple regression analysis indicated that the resting tongue position and maximum occlusal force before the expansion treatment were significantly associated with the amount of palate expansion. Conclusions Slow plate expand can expansion the basal palate. Moreover, oral function improves after expansion therapy.

Prevalence of Dental Trauma and Their Relationship to Risk Factors among 8-15-Year-Old School Children.

Tooth injuries lead to functional, aesthetic, and psychological disorders, accompanied by the great concern of the child, the parents, and the dentist. (a) To assess the prevalence of traumatic dental injury (TDI) and its relationship to risk variables among 8-15-year-old school children in Mahbubnagar, India. (b) To collect baseline data as there are limited reports of TDI studies in South India to date. A cross-sectional study was conducted among 6643 children from 78 schools in Mahbubnagar using a multilevel random sampling method. The permanent incisors were examined according to the WHO classification using a standard oral mirror and probe. Individuals with clinical evidence of trauma were asked about the details of the injury event using a structured questionnaire. The chi-square test analyzed the distribution of all measurements in this study with a statistical significance of 0.05. Among the 6643 children from the 78 schools surveyed, 9.3% experienced TDI. TDI occurred in 68% of boys, which was about twice as high in girls at 32%. The most commonly affected teeth were the maxillary central incisors. A higher number of children with an incisal overjet more significant than 3 mm had TDI than the children less than 3 mm, although this difference was not statistically significant. The lip closure incompetence was more common in children with TDI. The most frequent causes of TDI were falls, and the site of occurrence was school. Type I fractures were the most prevalent and most went untreated. The high level of dental trauma and the low percentage of children with trauma seeking treatment emphasize the need for greater awareness among the Mahbubnagar children.

Voice2Face: Audio‐driven Facial and Tongue Rig Animations with cVAEs

AbstractWe present Voice2Face: a Deep Learning model that generates face and tongue animations directly from recorded speech. Our approach consists of two steps: a conditional Variational Autoencoder generates mesh animations from speech, while a separate module maps the animations to rig controller space. Our contributions include an automated method for speech style control, a method to train a model with data from multiple quality levels, and a method for animating the tongue. Unlike previous works, our model generates animations without speaker‐dependent characteristics while allowing speech style control. We demonstrate through a user study that Voice2Face significantly outperforms a comparative state‐of‐the‐art model in terms of perceived animation quality, and our quantitative evaluation suggests that Voice2Face yields more accurate lip closure in speech with bilabials through our speech style optimization. Both evaluations also show that our data quality conditioning scheme outperforms both an unconditioned model and a model trained with a smaller high‐quality dataset. Finally, the user study shows a preference for animations including tongue. Results from our model can be seen athttps://go.ea.com/voice2face.

Effect of oral motor facilitation technique on oral motor and feeding skills in children with cerebral palsy : a case study

Background:Deficiencies in oral motor function and feeding skills are common in children with cerebral palsy (CP). Oral motor therapy is a useful method to improve oral motor function and feeding skills. Oral motor facilitation technique (OMFT) is a newly designed comprehensive oral motor therapy, including postural control, sensory adaptation, breathing control, sensorimotor facilitation, and direct feeding.Methods:This study was performed to identify the effect of OMFT on oral motor function and feeding skills in children with CP. A total of 21 children with CP (3–10 years, GMFCS III–V) participated in 16 weeks (16 sessions) of OMFT. The effects on oral motor function and feeding skills were assessed using the Oral Motor Assessment Scale (OMAS) before the treatment, 8 and 16 weeks after OMFT. Data were analyzed using the Friedman test and post-hoc analysis.Results:Significant improvement was found in oral motor function and feeding skills including mouth closure, lip closure on the utensil, lip closure during deglutition, control of the food during swallowing, mastication, straw suction, and control of liquid during deglutition after OMFT. Mouth closure was the most effective and mastication was the least effective item. Sixteen weeks is more effective than 8 weeks of OMFT.Conclusion:OMFT could be an effective and useful oral motor therapy protocol to improve oral motor function and feeding skills in children with CP.

In situ quantitative assessment of food oral processing parameters: A review of feasible techniques and devices.

Oral processing is a combination of various actions, the detailed description of which has always been the subject of relevant research. By means of imaging technology and sensory evaluation, more knowledge of oral processing have been accumulated. Presently, the advances in sensory technology have added quantitative parameters to the qualitative description of oral processing, which also enriched the specifics of each action. Previous studies have shown that oral processing includes lip closure, dental occlusion, masticatory muscles activity, tongue movement, and swallowing, whose processing contains rich information such as the movement of organ and the intensity of organ contacts. "Quantification" was taken in this review as the basic feature of in situ detection information, the relevant parameters and feasible methods for the quantitative description of each activity was recorded in detail. In addition, basic problems and feasible optimization schemes of the existing in situ detection device are also proposed in the hope of promoting the development of in situ detection device thus providing available information for the description of oral processing.

Timing of smile suppression during the articulation of labials in smiled speech

Past studies have shown that opposing forces on the lips can be reconciled by suppressing a smile during speech-related lip closure movements [Liu et al., 2020, ISSP]. However, the exact timing of this suppression on the smiling posture remains unknown. The purpose of this study was to determine the onset and duration of smile suppression during labial production in smiled speech. We collected video footage of participants reading sentences that contain labial sounds (/m, f, v, b, p, w/) under three facial posture conditions (neutral, smile, laugh), and extracted short video clips of the labial sound productions. We then analyzed the extent of lip spreading in each facial posture condition using OpenFace 2.0 [Baltrušaitis et al., 2018, IEEE]. Our preliminary results show that smile is suppressed in the smiling and laughing conditions, with attenuation beginning approximately 300ms prior to labial sound production, and continuing for about 600ms regardless of conditions. Further analysis will investigate the duration of suppression after the offset of labials and will be conducted on more participants.

The study on the morphological changes of oropharynx in patients with complete unilateral cleft lip and palate after palatopharyngeal closure.

Cleft lip and palate can be treated as one of the most common craniofacial congenital malformations in humans. Such disease influences tens of millions of patients all over the world. Cleft lip and palate deformity affects many important physiological functions, including breathing, swallowing, speech, chewing, and aesthetics. This work focuses on investigating the morphology and airway volume of oropharynx patients with unilateral complete cleft lip and palate after palatopharyngeal closure. In addition, this work evaluated the similarities and differences between patients with cleft lip and palate and those without such an issue. The employed data, selected from the Department of Stomatology of Xuzhou First People's Hospital, are based on the conical beam CT images. The study sample was divided into two groups: the selected experimental group, who confronted the cleft lip, cleft palate, and velopharyngeal closure surgery, and the selected control group, who are healthy children at the corresponding age. The parameters, including the airway volume, the airway volume of velopharyngeal and oropharyngeal segments, the minimum cross-sectional area of the pharynx, the horizontal plane airway area of the hard palate and soft one, the horizontal airway area of the hyoid bone, and the vertical distance between the hard palate and soft palate, can be measured by Dolphin. These parameters were analyzed with a statistical approach. The analysis of the above-mentioned parameters reveals that the airway volume, the minimum cross-sectional area of the pharynx, the horizontal cross-sectional area of the hyoid, and the distance between the hard palate and soft palate tip in patients with complete unilateral cleft lip and palate show significant differences between the experimental group and the control group. Meanwhile, other parameters, including the horizontal cross-sectional area of the airway in the horizontal plane of the hard palate and the horizontal plane of the soft palate, did not show noticeable differences in the two groups. The patients, who confronted the unilateral complete cleft lip and palate, can improve with the velopharyngeal closure surgery. Furthermore, the length and vertical distance of the soft palate and the volume of each segment of the airway exhibit differences between the experimental group and the control group.

Videofluorographic Analysis of Swallowing Function after Total Glossolaryngectomy.

Surgeons have traditionally believed that swallowing is mainly dependent on gravity after total glossolaryngectomy. However, swallowing function after total glossolaryngectomy varies widely among patients, and a thorough analysis is lacking. The authors aimed to clarify the swallowing function after total glossolaryngectomy and determine whether it is primarily dependent on gravity. The authors retrospectively analyzed videofluorographic examinations of patients who underwent total glossolaryngectomy and free or pedicle flap reconstruction. The authors enrolled 20 patients (12 male; mean age, 61 years; age range, 43 to 89 years). All patients demonstrated constriction of the reconstructed pharynx to some degree, and no patient's ability to swallow was dependent on gravity alone. Videofluorography showed excellent barium clearance in eight patients and poor clearance in 12. All patients with excellent clearance showed strong constriction of the posterior pharyngeal wall, whereas only 8.3 percent of the patients with poor clearance showed adequate constriction, which was significantly different ( p = 0.0007). Velopharyngeal closure and lip closure also contributed significantly to excellent clearance ( p = 0.041). The shape of the reconstructed pharynx (depressed, flat, protuberant) showed no statistically significant association with excellent clearance. Contrary to previous understanding, constriction of the remnant posterior pharyngeal wall played an important role in swallowing after total glossolaryngectomy, and gravity played a secondary role. Dynamic posterior pharyngeal wall movement might result from the increased power of the pharyngeal constrictor muscle and compensate for the immobility of the transferred flap. A well-functioning pharyngeal constrictor muscle and complete velopharyngeal and lip closures can contribute to excellent barium clearance in patients after total glossolaryngectomy. Therapeutic, III.

Happy Smile of a New-Born Infant with Cleft Lip and Cleft Palate

Background: Cleft palate of the new-born infants with or without cleft lip, are recognized to be at risk of feeding difficulties, making it difficult to maintain adequate nutrition, and also interfere the speech function and the parents also their psychological growth. Purpose: Surgical closure of the cleft lip may be accomplished shortly after birth to relieve the parents’ anxiety as long as the general rules “ triple tens ” ( more than : 10 week of age, 10 pounds of body weight, 10 grams of haemoglobine ) that is frequently used in determining optimum timing for lip closure must be fulfilled. Case Report: Female baby at age 5 days, who was referred to pediatric dentistry clinic dr. Ramelan Naval Hospital Surabaya with parents complaining that their baby was born with cleft lip and palate and could not drink breast milk, easily choked, so they had to depend on the sonde. Case management: A maxillary feeding plate (=MFP) was made to close the cleft palate and regenerate the function of chewing and swallowing so that the infant obtains good nourishment and gain body weight until the palatal cleft closure operation. Conclusion: After the closure, her mother and family are psychologically able to prepare comprehensive protection for the child so that they too feel comfortable and confident. Smile can represent 80% of communication. When children feel comfortable because they can freely smile, this smile can attract other people to make it easier to adapt and socialize.

CONGENITAL EPULIS—A RARE TUMOUR

Congenital epulis is a rare, benign soft tissue condition with a female preponderance that is only seen in newborns. It arises from the alveolar mucosa and occurs more frequently in the maxilla and protrudes out of the infant's mouth. This condition may interfere with feeding, lip closure, or respiration and even potentially obstruct the airway. This work presents the case of a female infant with a solid ovoid mass protruding from the oral cavity. Treatment of this lesion was surgical, and histopathologic examination confirmed clinical diagnosis of congenital epulis. Postsurgical follow-up was without complications; examination of the infant 2 months later revealed no sign of recurrence. Congenital epulis is a rare, benign soft tissue condition with a female preponderance that is only seen in newborns. It arises from the alveolar mucosa and occurs more frequently in the maxilla and protrudes out of the infant's mouth. This condition may interfere with feeding, lip closure, or respiration and even potentially obstruct the airway. This work presents the case of a female infant with a solid ovoid mass protruding from the oral cavity. Treatment of this lesion was surgical, and histopathologic examination confirmed clinical diagnosis of congenital epulis. Postsurgical follow-up was without complications; examination of the infant 2 months later revealed no sign of recurrence.

The Volume-Viscosity Swallowing Test – Portuguese Version: Validation and prevalence of safety and efficacy clinical signs in acute stroke patients

PurposeThe early identification of oropharyngeal dysphagia (OD) in patients after an acute stroke using non-invasive and easily administered instruments can minimize its consequences and reduce comorbidity and mortality. The Volume-Viscosity Swallow Test (V-VST) is a screening test that makes it possible. The goal of this study is to contribute to the validation of the V-VST European Portuguese (V-VST: EP) version and study the prevalence of safety and efficacy signs in acute stroke patients. MethodThe V-VST: EP, its instructions manual and algorithm, was presented to a panel of experts, to assess its content validity. It was applied to 33 acute stroke patients, with signs of OD, to analyze its psychometric properties. Finally, the prevalence of impaired signs of safety and efficacy was analyzed. ResultsThe V-VST: EP and its instruction manual (content) demonstrate very good agreement values. Most of the results for inter and intra-evaluator reliability presented Cohen's kappa values higher than 0.60 or 0.80 (75.0%). The concurrent validity (against the 3 OZ wst) presented a sensitivity of 100% and a specificity of 57.1%. For evaluator 1, the results presented are for the nectar, liquid and pudding consistencies, the prevalence values for the 5 ml, 10 ml and 20 ml volume capacity was: impaired lip closure (36%, 39%, 18%), piecemeal deglutition (50%, 50%, 50%), oral residue (7%, 0%, 9%), pharyngeal residue (25%, 17%, 9%) and safe swallowing (89%, 33%, 94%), respectively.

Expiratory Muscle Strength Training for Drooling in Adults with Parkinson’s Disease

One of the most debilitating symptoms of advanced Parkinson’s disease is drooling. Currently, the main treatment that is offered for drooling is botulinum toxin injections to the saliva glands which have a number of side effects and do not treat the causes of drooling, such as impaired swallowing and lip closure. This study explored the effect of an alternative therapy approach for drooling that aimed at improving the swallow, expiratory muscle strength training (EMST). Sixteen participants received EMST over a 6- to 8-week period. Measurements were taken pre- and post-training for drooling (Sialorrhea Clinical Scale for Parkinson’s Disease; SCS-PD), swallowing, lip strength and peak cough flow. Measures of drooling, swallowing and peak cough flow were stable over pre-training assessments and improved following training (p < 0.01). The most conservative estimate of the within-group change for SCS-PD was − 2.50 (95% confidence interval − 3.22 to − 1.22). No adverse effects were reported and participants gave high satisfaction ratings for the training. A programme of EMST offers promise as a therapy to reduce drooling for people with Parkinson’s disease. Adequately powered randomised controlled trials of EMST are now needed.