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Doctoral Thesis
DOI
https://doi.org/10.11606/T.61.2016.tde-17102016-103350
Document
Author
Full name
Tatiane Totta
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2016
Supervisor
Committee
Genaro, Katia Flores (President)
Felicio, Claudia Maria de
Soares, Simone
Teixeira, Marcelo Lucchesi
Trindade Junior, Alceu Sergio
Title in Portuguese
Análise do padrão mastigatório em indivíduos com fissura labiopalatina
Keywords in Portuguese
Eletromiografia
Fenda labial
Fissura palatina
Mastigação
Abstract in Portuguese
A reabilitação da fissura labiopalatina (FLP) restringe o crescimento da maxila e gera a deformidade dentofacial, que pode alterar a função mastigatória. Foi hipotetizada a existência de uma adaptação funcional da atividade muscular mastigatória, identificada pela distribuição compensatória da atividade eletromiográfica entre os músculos masseter e temporal, e entre os lados com e sem fissura. Participaram 54 adultos de ambos os gêneros: 24 com FLP unilateral operada, com mordida cruzada posterior bilateral, que aguardavam a realização da cirurgia ortognática (GF) e 30 indivíduos controle (GC). Todos foram submetidos à avaliação clínica e eletromiográfica da mastigação. A avaliação clínica dos tipos mastigatórios (TM) foi realizada pela análise porcentual dos ciclos mastigatórios na mastigação de biscoito. Índices padronizados e normalizados da eletromiografia de superfície foram obtidos pela análise quantitativa de sinais eletromiográficos diferenciais dos pares de músculos masseteres e temporais, e utilizados para descrever a ação muscular na máxima contração voluntária (MCV) e na mastigação unilateral de goma de mascar. Comparado ao GC, o GF apresentou menor ocorrência de TM bilateral alternado e maior presença de TM unilateral preferencial grau II (p<0,05). A hipótese de adaptação funcional entre a musculatura mastigatória não foi confirmada para o GF, no entanto, a hipótese foi confirmada quanto à adaptação funcional da atividade muscular mastigatória entre os lados íntegro e com fissura. Quando comparado ao GC, o GF evidenciou menor distribuição simétrica da atividade muscular dos pares de músculos masseter e temporal (POC) e presença de maior força de deslocamento lateral na MCV; além de menor atuação dos músculos temporais no lado de trabalho e maior recrutamento da musculatura do lado de não trabalho; com menor reprodutibilidade e coordenação neuromuscular do padrão mastigatório, gerando menor simetria entre ambas as mastigações unilaterais (p<0,05). Na comparação entre os lados com e sem fissura, não houve diferenças quanto às frequências mastigatórias, as elipses de confiança e as Fases em ambas as mastigações unilaterais (p>0,05). Indivíduos com FLP e TM bilateral alternado apresentaram médias reduzidas de POC masseteres e temporais, e maior força de deslocamento lateral na MCV; além de menor atuação dos músculos temporais no lado de trabalho e menor simetria entre as mastigações unilaterais, quando comparados ao GC.
Title in English
Analysis of the chewing pattern in individuals with cleft lip and palate
Keywords in English
Cleft lip
Cleft palate
Electromyography
Mastication
Abstract in English
Rehabilitation of cleft lip and palate (CLP) restricts the maxillary growth and gives rise to dentofacial deformity, which may alter the chewing function. It has been assumed that there is functional adaptation of the chewing muscle activity, identified by the compensatory distribution of electromyographic activity between the masseter and temporal muscles, and between cleft and non-cleft sides. Fifty-four adults (CLG: 24 with CLP; CG: 30 controls) of both genders were evaluated. The CLG was composed by operated unilateral CLP, who exhibited bilateral posterior crossbite, and were undergo in orthodontic treatment before orthognathic surgery. Both groups were submitted to clinical and electromyographic evaluation of chewing. Clinical evaluation of chewing types (CT) was performed by the percentage analysis of chewing cycles during biscuit chewing. Standardized and normalized scores of surface electromyography were obtained by quantitative analysis of differential electromyographic signs of pairs of masseter and temporal muscles, which were used to describe the muscular action in maximum voluntary contraction (MVC) and in unilateral mastication of chewing gum. Compared to CG, the CLG presented lower occurrence of alternate bilateral CT and greater presence of preferential unilateral CT grade II (p<0.05). The hypothesis of functional adaptation between the chewing muscles was not confirmed for CLG. However, the hypothesis was confirmed concerning the functional adaptation of chewing muscle activity between the cleft and non-cleft sides. When compared to CG, the CLG exhibited lower symmetric distribution of the muscular activity from the pair of masseter and temporal muscles (POC) and presence of lateral displacement force in MVC; besides lower action of temporal muscles on the working side and greater recruitment of muscles on the no working side; with lower reproducibility and neuromuscular coordination of the chewing pattern, giving rise to less symmetry between both unilateral chewings (p<0.05). Between the cleft and non-cleft sides there were not differences concerning the chewing frequencies, confidence ellipses and Phases in both unilateral chewings (p>0.05). Individuals with CLP and alternate bilateral CT presented lower mean POC for the masseter and temporal muscles, and greater force of lateral displacement in MVC; besides lower action of temporal muscles on the working side and less symmetry between unilateral chewings, when compared to CG.
 
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Publishing Date
2016-10-20
 
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