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Evaluation of occlusion, oral functions and quality of life in children with unilateral cleft lip and palate

Authors: Montes, Ana Bheatriz Marangoni, 1983-;

Evaluation of occlusion, oral functions and quality of life in children with unilateral cleft lip and palate

Abstract

Orientadores: Taís de Souza Barbosa, Maria Beatriz Duarte Gavião Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba Resumo: Objetivos: Avaliar as funções orofaciais e a qualidade de vida relacionada à saúde bucal (QVRSB) e suas associações (Estudo 1) e verificar a relação das funções orofaciais com a maloclusão, performance mastigatória e paladar em crianças com fissura unilateral de lábio e palato (FULP) (Estudo 2). Material e Métodos: Estes estudos caso-controle foram compostos por pacientes com FULP (selecionados no Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo ¿ HRAC/USP, Bauru, SP) sob o mesmo protocolo de tratamento, pareados por gênero e idade com os controles (selecionados de escolas públicas de Piracicaba, SP), totalizando 54 crianças de oito a dez anos de idade em cada grupo. O Estudo 1 utilizou as versões em Português Brasileiro do Nordic Orofacial Test-Screening (NOT-S) e do Child Perceptions Questionnaire (CPQ8-10) para avaliar as funções orofaciais e a QVRSB, respectivamente. O Estudo 2 avaliou a presença e gravidade de maloclusões dos pacientes utilizando o Goslon Yardstick Index (GYI) e dos controles pelo Índice de Necessidade de Tratamento Ortodôntico ¿ Componente Dentário (IOTN). Em ambos os grupos foi avaliada a performance mastigatória utilizando alimento teste artificial (Optocal) e a percepção do paladar utilizando quatro soluções líquidas (doce, salgado, amargo e azedo) em três diferentes concentrações. A análise dos dados consistiu de estatística descritiva, testes de comparação e correlação e análise de regressão linear para verificar as variáveis independents associadas com os escores do NOT-S. Resultados: No Estudo 1, o grupo FULP apresentou maiores escores do NOT-S (4,3 vs. 2,8, p?0,0001), isto é, apresentaram mais frequentemente disfunções relacionadas à respiração, simetria/expressão facial e fala. O grupo FULP apresentou pouca diferença em relação a QVRSB do grupo controle, com maior comprometimento do domínio bem-estar social. Na análise de correlação, os escores do CPQ8-10 estiveram positivamente correlacionados com os escores do NOT-S total e entrevista no grupo FULP. O estudo 2 verificou que mais de metade das crianças com FULP necessitavam de cirurgia ortognática (escore GYI = 5), enquanto 66,7% dos controles apresentou leve/pequena necessidade de tratamento (escore IOTN = 2), sendo que não houve associação entre a maloclusão e as disfunções orofaciais. O grupo FULP apresentou pior performance mastigatória (maiores valores do X50 e valor de b) e menor percepção do sabor salgado do que os controles. Além disso, houve correlação positiva entre a disfunção orofacial e a performance mastigatória no grupo FULP. Na análise de regressão linear múltipla, também observou-se relação significativa entre a disfunção orofacial e a performance mastigatória. Conclusões: A presença de FULP foi associada com disfunções orofaciais, resultando no comprometimento dos aspectos sociais do dia a dia, além de acarretar prejuízos à oclusão, a performance mastigatória, percepção de paladar Abstract: Objectives: To evaluate the orofacial functions and oral health-related quality of life (OHRQoL) and their associations (Study 1) and to assess the relation between orofacial dysfunctions with malocclusion, masticatory performance and taste in children with cleft lip and palate (UCLP) (Study 2). Material and Methods: Both case-control studies were composed by patients with UCLP (selected from the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP) under the same treatment protocol, matched by gender and age with controls (selected from public schools of Piracicaba, SP), totalling 54 eight- to ten year-old children in each group. Study 1 used the Brazilian Portuguese versions of the Nordic Orofacial Test-Screening (NOT-S) and the Child Perceptions Questionnaire (CPQ8-10) to evaluate orofacial dysfunctions and OHRQoL, respectively. Study 2 evaluated the orthodontic treatment need of patients using the Goslon Yardstick Index (GYI) and controls using the Index of Orthodontic Treatment Need ¿ Dental Health Component (IOTN-DHC). In both groups, masticatory performance was assessed by calculating the median particle size (X50) and distribution of particles in different sieves (b value)with artificial food test (Optocal); and taste perception using four liquid solutions (sweet, salty, bitter or acid) in three different concentrations. Data analysis involved descriptive statistics, comparison and correlation tests and linear regression analysis to verify the independent variables associated with NOT-S scores. Results: In Study 1, the UCLP group had higher scores NOT-S (4.3 vs. 2.8, P?0.0001), ie, were more often disorders related to breathing, symmetry / facial expression and speech. The UCLP group showed little difference from QVRSB the control group, with greater involvement of the social well-being domain. In the correlation analysis, CPQ8-10 scores were positively correlated with the scores of the total NOT-S and interview UCLP group. Study 2 The descriptive analysis showed that found that more than half of children with Fulp needed orthognathic surgery (GYI = 5 score), while 66.7% of the controls showed a slight / small need for treatment (IOTN score = 2), no association between malocclusions and orofacial disorders. In comparison analysis, UCLP group had higher scores NOT-S examination, that is, more often disorders related to breathing, symmetry / facial expression and speech. In addition, UCLP group reported greater involvement of the social welfare field than controls. The UCLP group had worse masticatory performance (higher values X50 and value b) and lower perception of salty taste than controls. In the correlation analysis, CPQ8-10 scores were positively correlated with the scores of the total NOT-S and interview UCLP group. In addition, there was a positive correlation between masticatory performance impairments and the orofacial dysfunction in UCLP group. In the multiple linear regression analysis also found a significant relationship between orofacial dysfunction and performance mastigatória. Conclusions: The presence of UCLP was associated with orofacial dysfunctions, resulting in the impairment of the social aspects of everyday life, besides causing damage to masticatory performance, perception of taste. Descriptive analysis showed that more than half of children with UCLP needed orthognathic surgery (GYI score = 5), while 66.7% of controls had slight treatment need (IOTN score = 2), and there was no association between malocclusion and orofacial disorders. In comparison analysis, UCLP group had higher NOT-S examination scores than controls, i.e., more frequent dysfunctions related to breathing, facial symmetry/expression and speech. Moreover, UCLP group reported more negative impacts on CPQ social well-being domain than controls. UCLP group Objectives: To evaluate the orofacial functions and oral health-related quality of life (OHRQoL) and their associations (Study 1) and to assess the relation between orofacial functions with malocclusion, masticatory performance and taste in children with cleft lip and palate (UCLP) (Study 2). Material and Methods: Both case-control studies were composed by patients with UCLP (selected from the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP) under the same treatment protocol, matched by gender and age with controls (selected from public schools of Piracicaba, SP), totaling 54 eight- to ten year-old children in each group. Study 1 used the Brazilian Portuguese versions of the Nordic Orofacial Test-Screening (NOT-S) and the Child Perceptions Questionnaire (CPQ8-10) to evaluate orofacial functions and OHRQoL, respectively. Study 2 evaluated the orthodontic treatment need of patients using the Goslon Yardstick Index (GYI) and controls using the Index of Orthodontic Treatment Need ¿ Dental Health Component (IOTN-DHC). In both groups, masticatory performance was assessed with artificial food test (Optocal); and taste perception using four liquid solutions (sweet, salty, bitter or acid) in three different concentrations. Data analysis involved descriptive statistics, comparison and correlation tests and linear regression analysis to verify the independent variables associated with NOT-S scores. Results: In Study 1, the UCLP group had higher scores NOT-S (4.3 vs. 2.8, P?0.0001), ie, were more often disorders related to breathing, symmetry / facial expression and speech. The UCLP group showed little difference from QVRSB the control group, with greater involvement of the social well-being domain. In the correlation analysis, CPQ8-10 scores were positively correlated with the scores of the total NOT-S and interview UCLP group. Study 2 The descriptive analysis showed that found that more than half of children with Fulp needed orthognathic surgery (GYI = 5 score), while 66.7% of the controls showed a slight / small need for treatment (IOTN score = 2), no association between malocclusions and orofacial disorders. In comparison analysis, UCLP group had higher scores NOT-S examination, that is, more often disorders related to breathing, symmetry / facial expression and speech. In addition, UCLP group reported greater involvement of the social welfare field than controls. The UCLP group had worse masticatory performance (higher values X50 and value b) and lower perception of salty taste than controls. In the correlation analysis, CPQ8-10 scores were positively correlated with the scores of the total NOT-S and interview UCLP group. In addition, there was a positive correlation between masticatory performance impairments and the orofacial dysfunction in UCLP group. In the multiple linear regression analysis also found a significant relationship between orofacial dysfunction and performance mastigatória. Conclusions: The presence of UCLP was associated with orofacial dysfunctions, resulting in the impairment of the social aspects of everyday life, besides causing damage to occlusion, masticatory performance, perception of taste Doutorado Odontopediatria Doutora em Odontologia CNPQ 140170/2014-6 CAPES

Keywords

Fenda labial, Quality of life, Qualidade de vida, Cleft palate, Fenda palatina, Cleft lip, Maloclusão, Mastigação, Malocclusion

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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