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Objective: The objective of this study was to analyze masticatory characteristics in children from 7 to 10 years, and to compare these characteristics among normal weight, overweight and obese children. Methods: This is a cross-sectional study, conducted in northeast Brazil, with a sample of 160 children, aged 7 to 10 years. The authors evaluated: nutritional and dental status; food intake; masticatory parameters and orofacial myofunctional characteristics. The children were divided according to nutritional status into normal weight (n = 101), overweight (n = 33) and obesity (n = 26) groups. Results: The results showed that Obese children had a larger bite size (g) (median = 6.0, Q1-Q3 = 4.0-9.0, p = 0.049) and performed fewer masticatory sequences (median = 3.0, Q1-Q3 = 2.0-3.2, p = 0.024) than children with normal weight (median = 5.0, Q1-Q3 = 4.0-7.0; median = 4.0, Q1-Q3 = 3.0-5.0). Furthermore, obese children finished feeding in a shorter time (s) (median = 62.5, Q1-Q3 = 50.5-70.0, p = 0.039) than normal weight children (median = 66.0, Q1-Q3 = 56.5-78.0) and overweight children (median = 66.0, Q1-Q3 = 58.0-81.5). Conclusions: The present results suggest that obese children present changes in mastication, evidenced by larger bite-size, performing fewer masticatory sequences and rapid mastication, which may contribute to increased food consumption and the development of excess weight. [ABSTRACT FROM AUTHOR]

Objective: To describe systemic manifestations, the characteristics related to tooth eruption, and the occurrence of enamel defects in children with Congenital Zika Virus Syndrome (CZS). Material and Methods: Prospective case series based on nine children with confirmed CZS diagnosis assisted at a reference center in a municipality in the Northeast Region of Brazil. Through a structured interview directed to mothers, information related to prenatal, delivery, and postpartum periods was collected. Tooth eruption was monitored through clinical examinations for 36 months. The modified developmental defect of enamel index (DDE) was used to identify opacities and hypoplasia. Data were presented using descriptive statistics. Results: A high proportion (77.8%) had microcephaly, and 55.5% had low birth weight. Musculoskeletal disorders, swallowing difficulty, and self-injury practices were present in all children. Among the systemic findings, visual impairment (77.8%) and seizures (77.8%) were widely reported. Concerning disorders related to the stomatognathic system, bruxism (66.7%) and difficulty in sucking (33.3%) were present. For most children (77.8%), the deciduous right lower central incisor was the first tooth to erupt (minimum 8 months and maximum 17 months). Enamel defects were diagnosed in only two children (22.2%). Conclusion: A wide range of systemic manifestations was observed in children with CZS, including visual impairment and musculoskeletal disorders. Delayed eruption of the first deciduous tooth was also observed. Enamel defects were present in a small proportion of children. [ABSTRACT FROM AUTHOR]

Aims: To translate the Pictorial Representation of Illness and Self Measure (PRISM) instrument from German to Portuguese (Brazilian) and adapt it to the Brazilian cultural context, and then assess its reliability and validity in orofacial pain patients. Methods: The PRISM was translated to Portuguese then back-translated to German. The translated PRISM was evaluated by a multidisciplinary committee and administered as a pre-test to 30 Portuguese-speaking orofacial pain patients. Psychometric properties were obtained after testing 116 orofacial pain patients. Validity was obtained through correlation analyses of scores obtained from PRISM and other psychometric tests, including the Numerical Pain Scale (NPS), Insomnia Severity Index (ISI), and Hospital Anxiety and Depression Scale (HAD). Results: The adapted instrument showed high levels of reliability, proven by means of the test-retest procedure, and calculation of the Intraclass Correlation Coefficient (ICC = 0.991). Significant correlations were found between PRISM and the other tests. Correlation with NPS was moderate (-0.42), whereas correlations with ISI (-0.24), HAD-anxiety (-0.25), and HAD-depression (-0.22) were weak. Conclusion: The cross-cultural adaptation process of PRISM was successful and the adapted version offers reliable and valid psychometric properties in the Brazilian context. [ABSTRACT FROM AUTHOR]

Congenital Zika Syndrome (CZS) is a condition that has emerged only recently, bringing together multiple changes, including significant changes in the stomatognathic system, which may compromise sucking behavior and consequently the breastfeeding practice. The aim of this study was to investigate the breastfeeding behaviors in children with CZS. A longitudinal study was carried out in two reference centers in Northeastern Brazil. The nonprobabilistic sample consisted of 79 children diagnosed with physical, neurological, and behavioral alterations compatible with CZS. Information regarding the child, nutritive, and nonnutritive sucking behavior and changes related to the sucking reflex was collected. Data were presented through descriptive and inferential statistics. In the bivariate analyses, the chi-squared test was used and 5% significance level was adopted. The majority of children had severe microcephaly (59.7%). Breastfeeding was performed at birth in most of CZS children (89.9%) but only 36.6% of them presented exclusive breastfeeding in the six months of life. Bottle feeding and pacifier were used in 89.9% and 55.7%, respectively. Sucking and swallowing difficulties and occurrence of gastroesophageal reflux were observed in 27.8%, 48.0%, and 29.2% of children, respectively. Early weaning was associated with bottle feeding (p = 0.005) and pacifier sucking (p = 0.003). Although breastfeeding practice at birth constitutes a behavior adopted by most of mothers, adherence to this exclusive habit until the first six months of life was low since the children presenting a large number of comorbidities with direct interference in the suction reflex, sucking, and swallowing difficulty. [ABSTRACT FROM AUTHOR]

Context • SARS-CoV-2 is a new virus responsible for the outbreak of COVID-19. Studies have shown that the expression of ACE2 was found in the smaller salivary glands was higher than that in the lungs, suggesting that salivary glands may be a potential target of the virus. This may indicate that one of the main gateways to coronavirus infection is the oral cavity. Objective • This review intended to evaluate the comorbidities of the oral cavity and their relationships to COVID-19 and to show the benefits of homeopathic therapies as adjuvant treatments to increase oral and general health and mitigate the devastating effects of the coronavirus. Design • The authors conducted a narrative review of articles published in indexed journals and websites of dental institutions and the WHO. They were selected oral pathological manifestations, sleep disorders, mood, orofacial pain and bruxism, associated with the oral-facial manifestations of Covid-19 and articles of evidence of homeopathy in dentistry. Setting • Study done in Brazil with research professors in Homeopathy and Periodontics in universities. Results • Some studies report that patients who are more susceptible to anxiety and stress during the pandemic, due to social confinement, may have disorders in the stomatognathic system such as: neuralgic pain in the face and teeth, fractures of teeth and dental prostheses, nibbled mucosa, stomatitis, ulcers, pain in the Temporal Mandibular Joint, otalgias, dental tightening, bruxism, xerostomia, peeling of the mucous membranes and skin, facial paralysis. Conclusions • The researchers concluded that homeopathy is a safe and viable therapy for the control of COVID-19 symptoms, as scientific evidence has proven its benefits through clinical trials and use in previous epidemics. In dentistry, this therapy allows the dentist to act fully in the promotion of oral health and in the prevention of oral and systemic diseases. (Altern Ther Health Med. 2020;26(S2):112-116) [ABSTRACT FROM AUTHOR]

This epidemiological study was designed to find out the incidence and factors associated with the occurrence of intraosseous lesions diagnosed at a Reference Centre in Brazil. We included all patients diagnosed with intraosseous lesions (cyst, tumour, bone-associated lesion, and periapical disease) during the period 2006–2017, and analysed the association between some sociodemographic and clinical variables and the types of lesion. There was a total of 290 intraosseous lesions, the most common being odontogenic cysts. There was a significant association between age and odontogenic tumours (p = 0.001). In relation to the histopathological diagnosis, root cysts were the most common (n = 57), followed by dentigerous cysts (n = 26). The lesions studied were seen most often in women between the second and fourth decades of life, odontogenic cysts being the most common type found. We know of few publications of similar epidemiological work, either in Brazil or in the rest of the world, so we suggest that more such studies are made. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to evaluate lingual frenulum in children affected by congenital Zika syndrome (CZS) and to analyze the association of lingual frenulum phenotypes with other variables. Design: This present work had a cross-sectional, descriptive study design. Setting: This study was carried out in Fortaleza (Brazil). The health professionals provided tertiary level of care. Data collection occurred during a multidisciplinary task force for evaluating infants affected by CZS in December 2 to 3, 2016. Patients: Fifty-four patients with CZS (1-12 months old; 32 girls and 22 boys) were recruited from a population of 70 infants. Interventions: A multidisciplinary group comprised of speech-language pathologist/audiologists and pediatric dentists evaluated all patients through an intraoral examination and a specific tongue maneuver protocol for infants. Main Outcome Measures: Lingual frenulum visibility was the primary outcome measure. Before initiating the study, we hypothesized that children with CZS had an absent lingual frenulum. Results: Lingual frenula were visible in 34 (63%) infants, whereas in 20 (37%) infants lingual frenula visibility required a specific maneuver to retract the tongue. Six of 20 infants presented posteriorly positioned lingual frenula that were visible after maneuver. Lingual frenula were covered by mucous tissue in 14 infants. Presence of posterior frenulum was associated with dysphagia (P = 0.038). However, the presence of dysphagia in a multivariate model did not associate with the presence of a posterior lingual frenulum (P = .069) or neurologic symptoms (P = .056). Conclusion: Children with CZS showed predominance of a posterior lingual frenula covered by an overlapping curtain-like mucous membrane. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine the prevalence of bruxism in students at the Federal University of the Jequitinhonha and Mucuri Valleys in Brazil. The secondary objectives were to identify the factors associated with bruxism; prevalence of dental wear; and to distinguish the signs and symptoms of temporomandibular dysfunction when present, and verify its relationship with bruxism.Methods: Two hundred fifty-three students (106 males, 147 females) were clinically examined and answered a questionnaire. Trained researchers performed the dental wear evaluation. The incisal edge and occlusal surface were classified as follows: no wear, wear into enamel, wear into dentin, and extensive wear into dentin. Demographic data and factors related to bruxism were obtained by a questionnaire. The participants who presented dental wear and habit of clenching/grinding teeth were classified as bruxers. The data were analyzed by the SPSS program (p < 0.05).Results: The results showed that 31.6% of the students had bruxism. Of the 7084 teeth evaluated, 376 (5.3%) had some type of facet wear. The teeth that had the highest prevalence of wear facets were the canines. Stress, muscle pain, temporomandibular joint (TMJ) pain, and TMJ noise were significantly associated with bruxism (p < 0.001).Conclusion: The prevalence of bruxism was 31.6% in this population. The factors most associated with bruxism were stress, muscle pain, TMJ pain, and TMJ noise. [ABSTRACT FROM AUTHOR]

Objective: The parameters of orofacial dysfunction (OFD) in children can guide clinicians and researchers in the monitoring of deviations from normality. The aim for this study was to evaluate manifestation patterns and the prevalence of OFD in children.Materials and Methods: A population-based cross-sectional study was conducted involving 531 schoolchildren (8-10 years old) in a small city in southern Brazil. OFD was evaluated using the Nordic Orofacial Test-Screening (NOT-S). Poisson multiple regression analysis with robust variance was used to estimate adjusted NOT-S rate ratios (ratio of arithmetic means) among the different categories of covariables and their respective 95% confidence interval (RR: 95%CI).Results: The mean NOT-S score was 2.1 (SD 1.4, median: 2.0; range: 0-8). The majority of children (87.6%) had at least one domain of the scale affected. The most affected were Chewing and Swallowing (50.5%), Habits (41.4%) and Breathing (26.4%). NOT-S scores were lower among children from higher income families (RR = 0.73; 95% CI: 0.61-0.87) and higher among those with difficulty regarding access to dental services (RR = 1.14; 95% CI: 1.01-1.28), those with sleep bruxism (RR = 1.18; 95% CI: 1.04-1.32) and those with open bite (RR = 1.65; 95% CI: 1.42-1.93).Conclusions: The prevalence of OFD was high and both socioeconomic and clinical factors exerted an influence on NOT-S scores. [ABSTRACT FROM AUTHOR]

Objectives: To verify the influence of prominent mandibular tori on the functioning of the stomatognathic system.Methods: The participants included 40 individuals, divided into two groups: those with mandibular tori (GI group: 20 subjects) and those without mandibular tori (GII group: 20 subjects). The authors used the Myosystem-Br1 electromyography system to analyze electromyographic (EMG) activity. For muscle thickness, images of the masseter and temporalis muscles were captured using the NanoMaxx ultrasound. The maximal molar bite force was obtained by means of the Kratos digital dynamometer.Results: The EMG activity was higher in the masseter muscles in the GI group, compared with the GII group, in all clinical conditions assessed except for the mandibular at rest. In dynamic conditions, this higher EMG activity was also observed in the temporalis muscles. The GI group presented significantly less temporalis muscle thickness than seen in the GII group. The maximal bite force was significantly higher in the GI group.Conclusions: Mandibular tori promoted morphological and functional changes in the stomatognathic system. [ABSTRACT FROM AUTHOR]

There is no standardized protocol for the clinical evaluation of orofacial components and functions in patients with obstructive sleep apnea. The aim of this study was to examine the validity, reliability, and psychometric properties of the Expanded Protocol of Orofacial Myofunctional Evaluation with Scores (OMES-expanded) in subjects with obstructive sleep apnea. Patients with obstructive sleep apnea and control subjects were evaluated, and the validity of OMES-expanded was tested by construct validity (i.e. the ability to discriminate orofacial status between apneic and control subjects) and criterion validity (i.e. correlation between OMES-expanded and a reference instrument). Construct validity was adequate; the apneic group showed significantly worse orofacial status than did control subjects. Criterion validity of OMES-expanded was good, as was its reliability. The OMES-expanded is valid and reliable for evaluating orofacial myofunctional disorders of patients with obstructive sleep apnea, with adequate psychometric properties. It may be useful to plan a therapeutic strategy and to determine whether the effects of therapy are related to improved muscle and orofacial functions. [ABSTRACT FROM AUTHOR]

Purpose: to describe orofacial myofunctional findings, as well as the main otolaryngological, allergological and orthodontic problems found in mouth breathing children. Methods: 502 medical charts from the Mouth Breathing Outpatient Clinic from Hospital das Clínicas da Universidade Federal de Minas Gerais were analyzed. The subjects were aged between 2 and 12 years (median 6.0 years) and, about genders, 289 (57.6%) were male and 213 (42.4%) were female. The data collected was regarding general anamnesis, speech-language pathology evaluation, as well as the relevant parts of otolaryngological, allergological and orthodontic assessments. Data was submitted to statistical analysis. Results: at anamnesis, significant prevalence of maintaining the mouth opened (98.0%), snoring (89.9%) and nocturnal drooling (68.6%) was observed. Allergologic evaluation showed positive skin test (59.0%) and rhinitis (57.8%) and otolaryngological assessment revealed hypertrophic adenoids (91.7%) and tonsils (72.6%) and changed nasal mucosa (60.3%). The findings on orthodontic evaluation were malocclusion (86.8%), convex facial profile (62.9%) and overbite (55.5%). Data from speech-language pathology assessment indicated inappropriate usual lips position (70.5%), facial changes in lips (65.4%) and tongue (64.4%) strength, high hard palate (57.1%), altered nasolabial angle (57.0%) and asymmetry (55.0%). Conclusion: alterations were found on the evaluations made by all professionals, confirming the huge impact of mouth breathing on quality of life of those children, and therefore the need for multidisciplinary treatment for these patients. [ABSTRACT FROM AUTHOR]

Purpose: to investigate the association between stomatognathic functions of mastication and deglutition, dental occlusion and signs of temporomandibular disorders in asymptomatic women. Methods: the stomatognathic functions were assessed by the miofuncional orofacial exam; the dental occlusion exam included: Angle classification; measures of overjet and overbite; presence of openbite and crossbite; and the temporomandibular joint was examined by Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders. Results: 43 women with a mean age of 23.7 years were assessed. The miofuncional orofacial exam demonstrated changes in the mastication pattern (30.2%), atypical contractions during mastication (18.6%) and deglutition (58.1%). Regarding dental occlusion, Class I malocclusion (74.4%) was predominant, but no volunteer had an ideal occlusion. The evaluation of the temporomandibular joint showed range of motion within normal, presence of opening deviation (60.5%) and temporomandibular disorders diagnosis (16.3%). A significant association was found between presence of joint noises and diagnosis of temporomandibular disorders, joint noises and atypical deglutition contractions, mouth opening pattern and atypical contractions during mastication, and there was no association between occlusal Class Angle, mastication pattern and temporomandibular disorders. Conclusion: asymptomatic volunteers showed changes in stomatognathic functions as atypical contractions during deglutition and mastication, which were associated with the presence of joint noises and mouth opening pattern. These findings can be attributed to imbalances and lack of coordination of the muscles involved in these functions. No volunteer had ideal occlusion and no associations were found with this condition. [ABSTRACT FROM AUTHOR]

Purpose: to verify the compatibility between findings of facial measurements by caliper and perception of facial features made subjectively by an experienced evaluator. Methods: 24 female and 24 male subjects, paired for sex and age, without morphological and functional complaints of the stomatognathic system were evaluated. Aspects of symmetry between the middle and lower thirds, height and width of the face, and outer corner of the right and left eyes to the corners of the right and left respectively lip were evaluated. Each measurement was performed three times by a digital caliper to consider the average of these values, considering asymmetric comparisons with differences more than 4 millimeters. The width of the face was obtained through digital caliper fitted with extension 10 centimeters. The evaluation of the perception of facial features was performed by a blinded evaluator as to the digital caliper measurements that should point symmetries and asymmetries in these same evaluative aspects. Results: through the agreement Kappa and Chi- square test, it was possible to verify proper compatibility between the assessments, demonstrating the reliability of the methods used. Furthermore, it was found that there is a relationship between symmetry thirds of the face and assignment of facial typology on the perceptual evaluation, observing symmetry in medium and short faces and absence of a decisive standard for long faces. Conclusion: the characterization of facial symmetry by a digital caliper has a good compatibility with the subjective perception of an experienced evaluator. [ABSTRACT FROM AUTHOR]

Masticatory performance is determined not only through the speed of mastication, or by the quantity of food ingested; it also depends on the structures and functional integration of the stomatognathic system (SS). Objectives: this study investigated differences in the SS and orofacial motricity between obese and normal - weight women. Method: a total of 18 obese women, with an average age of 28 ± 7.3 years and an average body mass index (BMI) of 37.4 ± 5.1 Kg/m2, and 18 normal - weight women, with an average age of 26 ± 7.6 years and an average BMI of 20.7 ± 1.8 kg/m2, took part in the study. During the speech therapy evaluation, chewing, the number of chewing strokes, and swallowing were observed. The posture, mobility and tonus of lips and tongue, morphology, mobility and tonus of cheeks were designated as normal or altered. The electrical activity of the anterior temporalis, the masticatory muscle was evaluated for both groups using surface electromyography (EMG), which was expressed in microvolts (µV) and registered as Root Mean Squares. Results: significant differences were found between the two groups in clinical evaluation. In surface EMG, the obese group showed asymmetry of electrical activity of the anterior temporalis. Conclusion: this study suggests that speech therapist investigation of the SS should be combined with interdisciplinary obesity management. [ABSTRACT FROM AUTHOR]

Abstract: When looking at developing countries, the prolonged intensive medical and nursing care required by many patients places extra demands on an already stretched healthcare budget. The purpose of this study was to verify the effectiveness of a systematic rehabilitative program for swallowing and oral-motor movements in intensive care unit patients with the diagnosis of tetanus. Forty-five patients who were clinically diagnosed with tetanus were included in the study. Participants were divided in two groups: GI – consisted of 18 tetanus patients who were consecutively admitted to the infectious disease ICU from January 2002 to December 2005, prior to the existence of a systematic swallowing and oral-motor intervention; GII – consisted of 27 tetanus patients who were consecutively admitted to the infectious disease ICU from January 2006 to December 2009 and were submitted to a specific rehabilitative management of swallowing and of the oral-motor movements. Results indicate that the proposed rehabilitative program reduced by approximately 50% the time patients remained in the ICU. The significant improvement observed in patients with tetanus who were submitted to the rehabilitative program for swallowing and oral-motor movements occurred in conjunction with a reduction in the amount of time necessary to reintroduce oral feeding, to decannulate and to remove the feeding tubes. In conclusion, swallowing/muscle exercise, in patients with severe/very severe tetanus, seem to promote the remission of muscle tension and seem to maximize functional swallowing. [Copyright &y& Elsevier]

The human mandibles belonging to Uruguayan population present some anatomic differences with those belonging to Brazilian population. This appears to be determined by racial and ethnic characteristics of each country. This study examined the morphological characteristics of 100 Uruguayan mandibles and compared them with similar number of Brazilian bones, using thirteen measurements stipulated by Humphrey et al. (1999). The significant variations in mean values were calculated by Mann-Whitney test (alpha=5%). Expressive discrepancies were observed between the two populations regarding some of analyzed dimensions. The Uruguayan mandibles showed higher values in almost all measurements when compared to the Brazilian ones, except for the mandibular symphysis height, which was lightly higher in Brazilian mandibles. Differences were observed in notch and ramus height, mandibular length, mandibular width, symphysis height and bicoronoid width. Several factors could be responsible for these morphological discrepancies, including functional and biomechanical adaptations of stomatognathic system, stimulated by different consistency of the diet or miscegenation. [ABSTRACT FROM AUTHOR]

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Abstract: The purpose of this study was to determine maximum bite force in molar and incisor regions in young Brazilian indigenous individuals, who have had a natural diet since birth, and compare the sample with white Brazilian individuals. To do this, individuals were paired one-to-one (same weight, height, and Class I facial pattern). A secondary purpose was to elucidate the relation between bite force and gender in both populations. Eighty-two Brazilians took part in this study. Participants were aged between 18 and 28 years and were divided into two groups: 41 Xingu indigenous individuals and 41 white Brazilian individuals, with 28 men and 13 women in each group. The inclusion criteria were: having complete dentition; normal occlusion; no neurological, psychiatric or movement disorders; no reports of toothaches; having satisfactory periodontal health; absence of large facial skeletal alterations (typical Class II and Class III individuals); and no previous treatments using occlusal splints. To measure maximum bite force, a digital dynamometer model IDDK (Kratos—Equipamentos Industriais Ltda, Cotia, São Paulo, Brazil) was used, with a capacity of 1000N, adapted for oral conditions. Assessments were made in the first molar (right and left) and central incisive regions. Results reveal that mean maximum bite forces in indigenous individuals of the right molar is 421N, left molar 429N and incisor region is 194N and for white individuals of the right molar is 410N, left molar 422N and incisor region is 117N. Comparing indigenous with white individuals, maximal bite force showed a tendency of being greater in the indigenous group. It was observed that the incisor region showed statistical significance (p <0.0005) but no significance was observed in the molar region. Moreover, indigenous men showed the highest bite force values. [Copyright &y& Elsevier]

Objective: To analyze published scientific evidence about the most common orofacial disorders in children with microcephaly associated with ZIKV infection., Methods: Through a scoping review, we respond to the search question was formulated: "What are the orofacial alterations in children with microcephaly associated with ZIKV?" It was performed a search in PubMed, EMBASE, Scopus, and Health Virtual Library. It was selected papers wrote in English, Portuguese, or Spanish. An evidence quality analysis was performed using the Agency for Healthcare Research and Quality classification., Results: It was included 11 studies performed in the Brazilian Northeast region. The studies were carried out between 2018 and 2020. The main related alterations were delay in the tooth-eruption and deformation in the oral structures., Conclusion: The results observed in our work show moderate scientific evidence regarding the association of ZIKV with orofacial alterations in children with microcephaly due to the classifications of the quality of evidence of each one of the included studies. The main changes reported were in the chronology of tooth eruption, alteration in teeth, and oral structures., (© 2021 Wiley Periodicals LLC.)

Multiple anatomic and functional risk factors contribute to Obstructive Sleep Apnea (OSA) in children, most of the screening tools only evaluate clinical symptoms. The aim was to describe the evaluation of the short orofacial myofunctional protocol (ShOM) in OSA children, and to analyze if the inclusion of orofacial myofunctional aspects would influence the screening sensitivity/specificity of the Sleep Clinical Record (SCR). Children from Brazil and Italy with sleep disordered breathing were evaluated by full night polygraphy, the SCR and the ShOM. For the analysis of the correlations, we normalized the distribution of the children based on the percentiles of the Apnea and Hypopnea Index (AHI). The children were divided in: Group1: first percentile AHI up to25% (cut-off value: AHI≤1.9); Group 2: second percentile from 25% to 75% (cut-off values: 1.9˂AHI≤7.9); Group3: third percentile AHI˃75% (cut = off value: AHI˃7.9). The findings of SCR and ShOM were compared for each group. ROC curve of the sensitivity and specificity of OSA diagnosis were compared for SCR alone and the combined results of SCR plus ShOM. 86 children, 47 girls, 4–11 years, were included, 34 children were obese and 20 overweight. OSA severity and obesity showed a positive correlation (p = 0.04). Mean ShOM score was 5.64 ± 2.27, with a positive correlation to the SCR (p = 0.002). In Group1, the SCR showed more nasal obstruction, arched palate and OSAS score/positive Brouilette questionnaire and the ShOM scored more alterations to breathing mode, breathing type (p = 0.01) and lip competence. In Group 3, we found more tonsillar hypertrophy, Friedman tongue position alteration (p < 0.001), malocclusion and obesity at SCR and more alterations in tongue resting position, tongue deglutition position and malocclusion at ShOM. The myofuntional evaluation contributed to the screening of OSA in children, while alterations of the tongue (resting and deglutition position) were observed in children with the highest AHI percentile. The combination of SCR and ShOM improved the sensitivity and specificity for the identification of pediatric OSA when compared to SCR alone. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to evaluate lingual frenulum in children affected by congenital Zika syndrome (CZS) and to analyze the association of lingual frenulum phenotypes with other variables., Design: This present work had a cross-sectional, descriptive study design., Setting: This study was carried out in Fortaleza (Brazil). The health professionals provided tertiary level of care. Data collection occurred during a multidisciplinary task force for evaluating infants affected by CZS in December 2 to 3, 2016., Patients: Fifty-four patients with CZS (1-12 months old; 32 girls and 22 boys) were recruited from a population of 70 infants., Interventions: A multidisciplinary group comprised of speech-language pathologist/audiologists and pediatric dentists evaluated all patients through an intraoral examination and a specific tongue maneuver protocol for infants., Main Outcome Measures: Lingual frenulum visibility was the primary outcome measure. Before initiating the study, we hypothesized that children with CZS had an absent lingual frenulum., Results: Lingual frenula were visible in 34 (63%) infants, whereas in 20 (37%) infants lingual frenula visibility required a specific maneuver to retract the tongue. Six of 20 infants presented posteriorly positioned lingual frenula that were visible after maneuver. Lingual frenula were covered by mucous tissue in 14 infants. Presence of posterior frenulum was associated with dysphagia ( P = 0.038). However, the presence of dysphagia in a multivariate model did not associate with the presence of a posterior lingual frenulum ( P = .069) or neurologic symptoms ( P = .056)., Conclusion: Children with CZS showed predominance of a posterior lingual frenula covered by an overlapping curtain-like mucous membrane.