Stomatognathic Function Research Articles

Orthognathic surgery and orthodontics associated with orofacial harmonization: Case report.

Introduction and importanceOrthognathic surgery aims to restore the functional and esthetic standards of the face and non-surgical or minimally invasive procedures have been optimizing the results of facial orthosurgical treatments. This case report aimed to show the use of minimally invasive techniques that, associated with orthognathic surgery, represent a trend in current oral and maxillofacial rehabilitation.Case presentationA female patient, 28 years old, white, sought care from the Dentistry team of the São Vicente de Paulo Hospital, in Passo Fundo, Brazil, complaining of mandibular prognathism, anteroposterior maxillary deficiency, dental crowding, malocclusion, functional and esthetic changes that negatively affected her psychosocial interactions and stomatognathic function. The treatment involved orthodontics, orthognathic surgery, and orofacial harmonization with dermal fillers.Clinical discussionThe multidisciplinarity among the specialties of Oral and Maxillofacial Surgery and Traumatology, Orthodontics, and Orofacial Harmonization add and contribute to the process of planning and implementing the treatment proposed, as well as the prognosis toward patient satisfaction.ConclusionThe surgical procedure associated with minimally invasive facial harmonization not only corrected the functional complaint of the patient but also played an important role in improving facial harmony, contributing significantly to self-esteem.

Evaluation of muscle activity and bite force in masticatory muscle after massage therapy or occlusal splint in sleep bruxism childhood

Objective: Sleep bruxism (SB) is considered masticatory muscle activities that occur during sleep, which can interfere in stomatognathic system function. When treatment occurs earlier, most of the signs and symptoms can be prevented. However, there are few studies about treatment in early ages. Thus, the present study aimed to evaluate muscle activity and bite force changes after massage therapy (MT) and the use of occlusal splints (OST) for children with SB. Methodology: Forty-eight children were divided into 4 groups after SB diagnosis, according to the American Academy of Sleep Medicine’s criteria: Group 1–without bruxism; Group 2–SB, MT treated; Group 3–SB, OST treated for 30 days; Group 4–SB, not treated. Children were submitted to initial and final bite force (BF) evaluations and muscular activity, using a digital dynamometer and BiteStrip®, respectively. The results were computed and statistical analysis performed using SPSS 20.0 program, with a significant level of 95% (p ≤ 0.05). Results: Significant differences were statistically found in muscle activity in Group 3 (p = 0.003) and BF in both Groups 2 (p = 0.001) and 3 (p = 0.007). Conclusion: Results indicate that the use of OST led to a reduction in muscle activity and increase on BF in children with SB, whereas MT did not alter muscle activity, but provided an increase on BF in these children.

Influencia de los hábitos orales en el perfil miofuncional orofacial de niños de tres a cinco años

Objetivo: Investigar la influencia de los hábitos orales en el perfil miofuncional de los niños de tres a cinco años. Material y métodos: Estudio transversal con 73 niños a través del protocolo de aplicación validado para la evaluación de los aspectos miofuncional orofacial y el cuestionario sobre los hábitos orales. Para el análisis de las variables, el nivel de significación fue del 5%. Resultados: La suma total de protocolo de Evaluación Miofuncional Orofacial con Valores (AMIOFE) fue de 91,6 ± 5,4 puntos (IC del 95%: 90,3 92,9), con un mínimo de 75 y un máximo de 100 puntos. Se observó relación significativa entre: la alimentación con biberón (p=0,014) y chupetes (p <0,001) con los aspectos y las posiciones de los articuladores; el uso del chupete y la función respiratoria (p=0,04) y la deglución (p=0,006); el uso de objetos en la boca y la función de masticación (p=0,001); la respiración oronasal y los aspectos y las posiciones de los articuladores (p <0,001) y la función de deglución (p=0,002). Además, la lactancia materna prolongada influyó positivamente el aspecto y la posición de los articuladores (p=0,001) y la función respiratoria (p=0,005). Conclusiones: Los hábitos de alimentación con biberón, los objetos en la boca, los chupetes y la respiración oronasal se relacionaron con cambios en los aspectos y posturas de los articuladores y las funciones estomatognáticas.

MYOFUNCTIONAL THERAPY IN ANTERIOR DEEP BITE AND TMD PATIENT-CASE REPORT

Deep bite is perhaps one of the most common dental malocclusions seen in children as well as in adults and is very demanding to be treated successfully. A skeletal or dental overbite is caused by genetic or environmental factors, or a combination of both. The ideal overbite in a normal occlusion may range from 2 to 4 mm. Mild deep bite typically requires no correction, unless correction for aesthetic reasons. Severe overbite, considered as a clinical problem may affect the temporomandibular joint, causes periodontal problems and tooth wearing, as well as traumatizing the incisive papilla or interfering with mastication function. Anterior deep bite could be caused by overeruption of upper and/or lower incisors or undereruption of posterior teeth. Correction of deep overbite has always been challenging to orthodontists, especially in adult cases. There are different modalities in orthodontic treatment of this malocclusion. Deep bite correction can be treated with intrusion of incisors, extrusion of posterior teeth, combination of both, and orthognathic surgical modality. The aim of this case report was to present treatment protocol for an adult patient with skeletal deep bite, Class II Division 1 malocclusion and temporomandibular disorder (TMD) managed with conventional orthodontics therapy combined with orofacial myofunctional exercises. The modality of exercise therapy included improvement of proprioception, tonicity and mobility, working with the facial and cervical musculature, as well as with stomatognathic functions - respiration, mastication, deglutition and speech. The most important thing is to aid long-term retention. Keywords: anterior deep bite, TMD, myofunctional therapy.

Perfil da qualidade de vida três meses ou mais após o término da radioterapia adjuvante utilizada para o tratamento do câncer de cabeça e pescoço em um Centro de Assistência de Alta Complexidade em Oncologia

The treatment of head and neck cancer (HNC) is multimodal and can generate different physical and psychological impairments. The aim of this study was to assess the quality of life profile of patients with HNC, in search of possible therapeutic targets that can be improved. This is a descriptive, cross-sectional, observational study, developed at a High Complexity Care Center in Oncology. Data were collected through anamnesis and the University of Washington quality of life questionnaire (UW-QOL). The sample consisted of 68 patients with head and neck cancer who underwent adjuvant radiotherapy for at least 90 days. There was a predominance of males (89%) and an involvement of the oropharynx (69%). In addition to radiation therapy, 53% of individuals also underwent surgery and 65% chemotherapy. Stomatognathic functions were the most affected, followed by negative implications related to activities of daily living and psychological aspects. According to the nature of the domains found in the UW-QOL Questionnaire, the low scores observed in the questions related to the activities of daily living and in the components of the psychological status assessment, it is pertinent to assume that the late complications imposed by both the pathophysiology of the HNC as well as the antineoplastic treatment should be approached by a multidisciplinary team aligned with the synergistic objective of rehabilitating stomatognathic functions, nutrition, and physical capacity. Although our data do not suggest emotional impairments, additional support from a psychologist could be considered in order to strengthen and motivate engagement in the rehabilitation of the complex clinical condition intrinsic to HNC.

Prótese dentária: influência nas funções estomatognáticas e na qualidade de vida

OBJETIVO: Compreender o impacto da prótese dentária nas funções estomatognáticas e na qualidade de vida dos usuários.MÉTODOS: A amostra foi composta por 50 indivíduos, de ambos os sexos, com idade superior a 18 anos, tendo como critério de inclusão o uso da prótese dentária total ou parcial. Foram excluídos do estudo indivíduos que apresentaram patologias neurológicas, síndromes e/ou dificuldade de compreensão. Na coleta de dados foi realizada avaliação das funções de mastigação, da fala e da deglutição baseada no protocolo MBGR. Para avaliar a qualidade de vida foi aplicado o questionário OHIP-14. Os dados foram analisados de forma descritiva e inferencial, considerando o nível de significância de 5% em todas as análises inferenciais.RESULTADOS: Dos 50 usuários de próteses dentárias, 62% eram do sexo feminino e 38% do sexo masculino, com idade média de 62 anos e 6 meses. Os participantes utilizavam prótese em média há 27 anos e 3 meses, sendo mais frequente o tipo de prótese dentária total (46%). Verificou-se que 78% da amostra apresentou mastigação alterada, 30% fala alterada e 10% deglutição alterada. Quanto ao questionário, 68% da amostra apresentou respostas indicativas de impacto na qualidade de vida.CONCLUSÕES: O uso da prótese dentária ocasiona alterações na função mastigatória principalmente no que se refere à incisão do alimento e ao padrão mastigatório. O tempo de uso pode influenciar na adaptação do indivíduo quanto às funções de fala e de deglutição. A qualidade de vida pode sofrer alterações devido ao uso de prótese.

An overview of patient-reported outcome measures to analyze the quality of life after orthognathic surgery

Society imparts great importance to physical appearance in this modern age. The physical and psycho-social impact of a dentofacial deformity on an individual is often impossible to assess with certainty. A facial deformity can profoundly affect the quality of life and thereby entailing lifelong adjustments. Facial aesthetics affect an individual's confidence and their overall acceptance in society, which in turn has an apparent effect on their quality of life. Corrective jaw surgeries are indicated in cases not amenable to produce acceptable post-treatment results with orthodontics alone. Orthognathic surgery aims to produce a more aesthetic facial appearance and strives to improve stomatognathic functions in the process. WHO defines Quality of Life as- An individual's perception of their position in life in the context of the culture and value systems in which they live and concerning their goals, expectations, standards and concerns. It is a broad-ranging concept affected in a complicated way by the person's physical health, psychological state, level of independence, social relationships, personal beliefs and their relationship to salient features of their environment. The impact of dentofacial deformities on an individual's holistic emotional, physical and social development has been a focus of research for a long time. Several patients reported outcome scales are employed to assess the quality of life and this review aims to discuss the use of these scales as an indicator of successful surgical treatment. At the same time, these scales may serve as a patient education tool because a holistic health indicator is required which considers the psychological well being of the patient along with regards to functional and aesthetic demands before formulating a surgical treatment plan.

Integral speech therapy evaluation protocol of the newborn and the relevance to the breastfeeding intervention

Countless studies carried out by different health areas demonstrate the benefits of exclusive breastfeeding (BF) and the harmonious growth of craniofacial structures for the proper subsequent development of oral functions such as breathing, swallowing and speech. Early intervention by the professional in speech therapy in Intensive Care Units (ICU) shows undeniable benefits as it promotes self-efficacy in the mother, breastfeeding and with it, the reduction of comorbidities in the baby, as well as the reduction of time for the implementation of the oral route. It is important to highlight the importance for the speech pathologist to have validated instruments that allow timely diagnoses and therefore effective treatments. This research is descriptive, with a mixed methodology and non-experimental design; Since it was oriented towards the verification of the validity of the content (external) of the EFIN Comprehensive Speech Therapy Assessment Protocol of the Newborn, also determining its relevance, as it is used as a guiding instrument within the role of the speech therapist in breastfeeding. For validity purposes in terms of sufficiency, relevance and clarity, the validation is carried out through the judgment of experts, with a panel made up of professionals from different Latin American countries, including Colombia, Peru, Chile, Brazil and Argentina, obtaining strong validity of the entire protocol, with a validity coefficient according to Aiken’s V statistical coefficient greater than 0.81. To measure the usefulness of the EFIN instrument in the approach to breastfeeding, a Likert-type survey is carried out observing homogeneous absolute frequencies that allowed us to see the instrument as a very useful tool, not only for breastfeeding but for all areas of neonatology in which the speech therapist participates. Keywords: Stomatognathic functions; communication; neonates; breastfeeding; speech therapy.

UNICYSTIC AMELOBLASTOMA: MURAL SUBTYPE

Unicystic ameloblastoma has 3 histologic variants. Mural subtype is the most aggressive. Histopathological examination shows fibrous wall cyst infiltration, forming conjunctive tissue islands, making possible the lesion return. The objective is to report the case of a 22-year-old patient with left hemiface lower third swelling for about 2 years. Facial asymmetry was observed, with vestibular filling, mobility in element 36; unilocular and circumscribed radiolucid image, with abroad of 5 cm in its greater diameter and with 38 tooth involved, covering body until mandibular ramus. In the incisional biopsy, decompression device was installed and performed for 4 months. In view of the high recurrence rate of this histologic subtype and the ineffectiveness of the instituted decompression, was chosen for the segmentary recession and osteosynthesis with reconstruction plate, to maintain the stomatognathic functions and space for future bone reconstruction. The patient is in the 12th month of observation without recurrence.

Biofotogrametric and electromyographic analysis in different position in women with temporomandibular disorder.

Introduction: The relationship established between TMJ (Temporomandibular Joint), cranium and cervical spine requires the synchrony of these structures for the proper performance of stomatognathic functions and muscle balance in this region. Objective: Evaluate the craniocervical posture and the electrical activity of masticatory and cervical muscles in sitting and standing positions in patients with TMD, correlating these variables. Method: The participants were 21 women, with mean age 28 ± 5.33 years and severe TMD. The participants were evaluated by electromyography of the masseter, anterior temporal and sternocleidomastoid (SCM) and upper trapezius muscles, bilaterally, in standing and sitting position. The body posture was evaluated by biophotogrammetry, with analysis of the Head Horizontal Alignment (HHA) and Acromion Horizontal Alignment (AHA) in frontal view and the Head Vertical Alignment (HVA) and Head Horizontal Alignment related to seventh cervical vertebra (HHAc7) in lateral view. Results: The electrical activity of masticatory muscles during resting did not differ between the different evaluated positions. During maximum intercuspation, the electrical activity was significantly lower in the left masseter (p=0.016), higher in the left anterior temporal muscle (p=0.046) and higher in the right (p=0.005) and left (p=0.015) upper trapezius muscles, in standing position when compared to sitting position. The photogrammetric values found were within the normal range. There was a significant and moderate negative correlation between the left SCM muscle and the right (r=0.386) and left (r=0.428) HHAc7 angle. Conclusions: Muscular electrical activity was modified with the change between sitting and standing positions, with an increase in cervical muscle recruitment and asynchrony of the masticatory muscles. Thus, it can be inferred that there is a postural destabilization with possible head anteriorization during maximum intercuspation, reinforcing the relation of synergy between the masticatory and cervical muscles.

Masseter-facial neurorrhaphy for facial palsy reanimation: What happens after masseter denervation? Histomorphometric and stomatognathic functional analysis

The aim of the present study was to analyse the consequences of masseter muscle denervation. In facial palsy surgical treatment, the masseteric nerve constitutes an important nerve source for facial reanimation due to its anatomical position and large amount of available axons.Computed tomography and/or magnetic resonance imaging were performed in 30 control subjects, and three radiologists separately measured the longitudinal diameter (LD), anteroposterior diameter (APD), transverse diameter (TD), and skeletal muscle area (SMA) of the masseter muscles as reference values. Regarding the facial palsy group, from 2009 to 2018, 11 patients (4 men and 7 women) were selected on the following inclusion criteria: diagnosis of unilateral facial paralysis, minimum follow-up of 14 months, absence of temporomandibular dysfunction, presence of complete dentition (to minimise bias of stomatognathic evaluation), complete clinical and radiological records. The mean LD, APD, TD, and SMA values of the healthy and denervated masseter muscles were obtained and compared. Stomatognathic function was clinically examined through mean mouth opening (MMO) and Maximum Bite Force (MBF). Furthermore, facial symmetry analysis (FSA) was carried out using EMOTRICS Software.Reference values obtained were as follows: mean LD = 69 ± 5.9 mm (range: 59–85 mm); mean APD = 40.2 ± 3.3 mm (range: 34–48 mm); mean TD = 15.5 ± 3.1 mm (range: 11–26 mm); and mean SMA = 43.8 ± 13.5 mm3 (range: 26–85.8 mm3). No statistically significant difference was observed between the healthy facial palsy groups's masseter muscles and reference values. As the latter, in denervated masseter muscles, no statistically significant difference was observed for APD value in contrast to LD, TD and SMA that showed statistically significant difference in comparison with control population (p < 0.05, CI 95%). Moreover fibro-adipose degeneration was consistently observed, with its degree being directly proportional to the denervation time. MMO and MBF mean values were, respectively, 54.75 mm in men, 44.4 mm in women and 705N.None of the latter showed a statistically significant difference with respect to the control population and the parameters present in the literature, indicating that masseter-facial neurorrhaphy is a safe and effective procedure for facial reanimation with good functional and aesthetic outcomes.

Evaluación de las Funciones Estomatognáticas Succión-Respiración-Deglución del neonato

Al conocer de manera detallada el desarrollo normal del sistema estomatognático y sus funciones, se crea un protocolo de evaluación para el neonato, que permita la identificación temprana de factores de riesgo y de posibles alteraciones. La validación de contenido se realizó a través del juicio de expertos, así mismo, se realizó el análisis de ítem y el análisis de confiabilidad a través del coeficiente de alfa de Cronbach. El estudio fue realizado con una población muestral de 400 neonatos, antes del egreso hospitalario; divididos en dos grupos según la edad gestacional. El diseño utilizado fue de tipo descriptivo-comparativo y la estadística utilizada fue no paramétrica, usando el estadístico de U de Mann – Whitney, con un valor de significación de mayor de 0.5 como regla de decisión para las comparaciones según la edad gestacional. A través del juicio de expertos se obtuvo un coeficiente entre 0.86 y 1.0 que denota la validez del mismo; la confiabilidad se realiza a través del alfa de Cronbach el cual alcanza un coeficiente de 0,892 constatando que es un instrumento altamente confiable, con adecuadas propiedades psicométricas. Se concluye el tipo de parto y edad gestacional influyen de manera determinante en el desarrollo de las funciones estomatognáticas primarias.

Functional Analysis of Rhythmic Jaw Movements Evoked by Electrical Stimulation of the Cortical Masticatory Area During Low Occlusal Loading in Growing Rats.

The maturation of rhythmic jaw movements (RJMs) and related neuromuscular control has rarely been studied in animals, though this process is essential for regulating the development of stomatognathic functions. Previous studies have shown that occlusal hypofunction during growth alters masticatory performance. However, little is known about patterns of cortically-induced RJMs under conditions of soft-diet feeding during development. The aim of this study is to clarify the effect of low occlusal loading on the pattern of cortically induced RJMs and related neuromuscular responses in growing rats. Sixty-four 2-week-old male albino Wistar rats were randomly divided into two groups and fed on either a normal diet (control) or soft diet (experimental) soon after weaning. At 5, 7, 9, and 11 weeks of age, electromyographic (EMG) activity was recorded from the right masseter and anterior digastric muscles along with corresponding kinematic images in RJMs during repetitive intracortical microstimulation of the left cortical masticatory area (CMA). Rats in both groups showed an increase in gape size and lateral excursion until 9 weeks of age. The vertical jaw movement speed in both groups showed no significant difference between 5 and 7 weeks of age but increased with age from 9 to 11 weeks. Compared to the control group, the average gape size and vertical speed were significantly lower in the experimental group, and the pattern and rhythm of the jaw movement cycle were similar between both groups at each recording age. EMG recordings showed no age-related significant differences in onset latency, duration, and peak-to-peak amplitude. Moreover, we found significantly longer onset latency, smaller peak-to-peak amplitude, and greater drop-off mean and median frequencies in the experimental group than in the control group, while there was no significant difference in the duration between groups. These findings indicate that a lack of enough occlusal function in infancy impedes the development of patterns of RJMs and delays the neuromuscular response from specific stimulation of the CMA.

What do we learn from brain imaging?—A primer for the dentists who want to know more about the association between the brain and human stomatognathic functions

The number of neuroimaging studies on the brain and oral sensorimotor functions has increased recently. Behind the dazzling "brain maps," what does the neuroimaging evidence truly tell us? What can dentists learn from it to improve clinical practice? We summarise the pros and cons of applying magnetic resonance imaging (MRI)-based neuroimaging to study oral behaviours of the dental patients. This is a narrative review of previous neuroimaging research of oral functions, focusing on MRI-related studies of human subjects. MRI has gained popularity in dental research due to its non-invasive nature, its approachability and its versatility in quantifying a variety of brain signatures. We argue that MRI-based neuroimaging is suitable for investigating the association between the between-individual variations in brain structure (eg grey matter volume)/brain functions (eg brain activation) and oral behaviours of the patients. Two specific topics of the daily dental practice, mastication and dental fear and anxiety, are discussed to exemplify the potential of neuroimaging methods. The methodological and interpretive limitations of MRI techniques are highlighted, and most importantly, we emphasise that the neuroimaging findings should be carefully interpreted given these limitations. MRI-based neuroimaging techniques can provide a better evaluation of the association between the brain and stomatognathic functions, which could be pivotal to the evidence-based clinical management of dental patients.

Conhecimento de mães sobre formas de aleitamento e hábitos deletérios

Introdução: O aleitamento materno exclusivo é fundamental até os seis meses, pois além de promover a saúde integral para o bebê, auxilia no desenvolvimento craniofacial e nas funções estomatognáticas. Objetivo: Investigar o conhecimento das mães sobre aleitamento materno, hábitos orais deletérios e outros métodos para ofertar a dieta ao bebê. Método: Trata-se de um estudo descritivo de caráter quantitativo. Foi aplicado um questionário semiestruturado com perguntas abertas e fechadas, em 80 mães de uma Clínica Escola de Fonoaudiologia, no período de junho a setembro de 2017. Resultados: 66,3% das mães possui idade entre 18 a 30 anos, 98,8% realizou pré-natal, 63,8% realizou aleitamento materno exclusivo até os seis meses de idade, a maioria (88,8%) demonstrou conhecimento acerca da amamentação exclusiva e 72,5% receberam informações sobre o aleitamento no hospital, 43,8% receberam informações sobre o uso da chupeta e 27,5% quanto ao uso da mamadeira. Observou-se que a mamadeira é a segunda forma mais conhecida para ofertar leite ao bebê, totalizando 52,7%. Em relação ao profissional que mais orientou sobre a amamentação, hábitos orais deletérios e utensílios de alimentação foi o enfermeiro (57,5%) e apenas 16,30% receberam orientações de fonoaudiólogos. Conclusão: Pode-se concluir que há grande adesão do aleitamento materno exclusivo, porém há ainda uma parcela que não realiza desta forma. As mães possuem conhecimento em relação à chupeta, mamadeira, aleitamento materno e outras formas de aleitar, porém, as informações sobre o Sistema Estomatognático estão escassas. Verificou-se que não houve muita atuação do fonoaudiólogo com essa população. Vale ressaltar que há maior número de enfermeiros, em comparação com o número de fonoaudiólogos.

Stepwise approach to functional and aesthetic full mouth rehabilitation of worn out dentition – A case report

Prosthodontic rehabilitation is the art and science of restoring and developing form, function and aesthetics of a patient. Treatment of severe worn out dentition with surface defects require full mouth rehabilitation to restore form and function of the masticatory apparatus to as near normal as possible. Full mouth rehabilitation continues to be the biggest challenge to any clinician in Restorative dentistry. It requires efficient diagnosis and elaborated treatment planning to develop ordered occlusal contacts and harmonious articulation in order to optimize stomatognathic function, health and aesthetics which then translates to patient's comfort and satisfaction. In this case report full occlusal reconstruction of generalized attrition with loss of vertical dimension was done using segmental arch technique with reorganizing approach following Pankey Mann Schuyler philosophy. Treatment plan requires an interdisciplinary approach with periodontal and endodontic therapies to achieve acceptable esthetics and function. Keywords: Full mouth rehabilitation, Worn out dentition, Pankey Mann Schuyler philosophy, Aesthetics, Functional rehabilitation.

Icariin prevents oestrogen deficiency-induced alveolar bone loss through promoting osteogenesis via STAT3.

ObjectivesAlveolar bone osteoporosis has attracted more and more attention because of its profound impact on stomatognathic function and treatment, but current treatments have not been targeted to alveolar bone and might even cause severe side effects. Thus, identifying the effects of anti‐osteoporosis agents on alveolar bone is essential. Icariin ameliorates metabolic dysfunction of long bones, but its effects on alveolar bone remain unclarified.Materials and methodsBMSCs were isolated from rat mandibles (mBMSCs). The osteogenic potential of mBMSCs and the signalling pathway involved under icariin treatment were measured by ALP and alizarin red staining, reverse transcription‐polymerase chain reaction (RT‐PCR), Western blotting and immunofluorescence. Dual‐luciferase assay, chromatin immunoprecipitation (ChIP) and co‐immunoprecipitation were used to investigate the molecular mechanism. Ovariectomized and sham‐operated rats treated with or without icariin were analysed by micro‐CT, TRAP staining and calcein double labelling.ResultsWe found that icariin promoted osteoblast differentiation of mBMSCs. Furthermore, STAT3 was critical for icariin‐promoted osteoblast differentiation, as indicated by increased phosphorylation levels in icariin‐treated mBMSCs, while preventing STAT3 activation blocked icariin‐induced osteoblast differentiation. Mechanistically, icariin‐promoted transcription of the downstream osteogenic gene osteocalcin (Ocn) through STAT3 and STAT3 bound to the promoter of Ocn. Notably, icariin prevented the alveolar bone osteoporosis induced by oestrogen deficiency through promoting bone formation.ConclusionsFor the first time, our work provides evidence supporting the potential application of icariin in promoting osteogenesis and treating alveolar bone osteoporosis.

EXERESIS OF SIALOLYTIASIS ASSOCIATED WITH CHRONIC FIBROSIS IN THE RIGHT SUBMANDIBULAR REGION

Introduction: Known as inflammation of the salivary glands, sialodenitis can be classified as acute, subacute or chronic. It has obstructive factors as its main causality concomitant with the rare occurrence of sialolithiasis. These, in turn, can have severe consequences such as salivary thickening, ductal ectasia and swelling, associated with pain in the affected region. It has an epidemiologically predilection for men and its diagnosis is made through imaging tests such as ultrasound and panoramic radiography as well as through the digit-palmar evaluation of the professional. Surgical exeresis has been studied as the best approach for these cases, avoiding loss of function or recurrence. Objective: To report the case of a 71-year-old female patient diagnosed by the Oral and Maxillofacial Surgery and Traumatology Service of the Federal University of Pernambuco of School Dentistry with sialolithiasis injury associated with chronic sialodenitis with fibrosis in the submandibular gland. Methodology: The methodology of the study was the search for articles on the subject, organization in a brief literature review and its comparison with the case report that was described. Results: The patient attended the service because she complained of increased volume in the right submandibular region and during anamnesis presented pain on palpation and presence of purulent secretion in the oral cavity. After analysis of the imaging exam, which resulted in well-defined radiopaque pathology in the right mandibular body region, the patient underwent general anesthesia for lesion excision. Postoperatively, the patient evolved without phlogistic signs and after 1 year showed perfect healing and absent recurrence. Conclusion: It is essential, based on the case presented, the good preparation of the Dentist so that the correct diagnosis and treatment choice corroborate for a better quality of life of patients with lesions that severely compromise their stomatognathic function.

Autologous Hematopoietic Stem Cell Therapy of the Subjects with Systemic Sclerosis: Electromyographic Results of the Masticatory Muscles.

Musculoskeletal system impairment is a major cause of functional alterations in subjects with systemic sclerosis. Autologous hematopoietic stem cell therapy (AHSCT) may have an important role in the treatment functional of systemic sclerosis patients. The aim of this pilot study was to assess whether AHSCT interferes with the electromyographic activity of the masseter and temporalis muscles of subjects with systemic sclerosis. Before transplantation, seven subjects with systemic sclerosis (mean age [± SD], 40.1 ± 9.6 years) underwent electromyographic analysis of the masseter and temporalis muscles in mandibular tasks at rest, right and left laterality, protrusion and maximum voluntary contraction. Two months after AHSCT, the subjects re-evaluated using the same methods. Data were analyzed using the repeated-measure test, with p&lt;0.05 considered to be statistically significant. Two months after AHSCT, there was reduction in normalized electromyographic activity in the dental clenching in maximal voluntary contraction, with significant differences, for the left temporal muscle (p=0.04). AHSCT in subjects with systemic sclerosis promotes alterations in stomatognathic system function, especially those related to electromyographic activity of masticatory muscles.

Orthodontic management of obstructive sleep-disordered respiratory disorders

Through his/her knowledge of cranio-facial growth, the orthodontist plays a leading role within the multidisciplinary team that tracks and treats sleep-disordered breathing (SDB) in children. Correction of craniofacial risk factors (maxillary deficiency and retrognathia) is commonly used by practitioners alongside orthodontic treatment such as OMA and RME in the optimal conditions afforded by childhood growth. Myofunctional therapies are performed to restore correct stomatognathic function and play a central role in the management of SDB in children. The orthodontist is therefore a key player in the medical treatment chain of these children.