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Pan Z, Liu L, Sun Y, Ma Y. A Study of the Effects of Motor Experience on Neuromuscular Control Strategies During Sprint Starts. Motor Control 2024; 28:362-376. [PMID: 38710481 DOI: 10.1123/mc.2023-0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 03/12/2024] [Accepted: 03/19/2024] [Indexed: 05/08/2024]
Abstract
Much of the current research on sprint start has attempted to analyze the biomechanical characteristics of elite athletes to provide guidance on the training of sprint technique, with less attention paid to the effects of motor experience gained from long-term training on neuromuscular control characteristics. The present study attempted to investigate the effect of motor experience on the modular organization of the neuromuscular system during starting, based on he clarification of the characteristics of muscle synergies during starting. It was found that exercise experience did not promote an increase in the number of synergies but rather a more focused timing of the activation of each synergy, allowing athletes to quickly complete the postural transition from crouching to running during the starting.
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Affiliation(s)
- Zhengye Pan
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Lushuai Liu
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Yuan Sun
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Yunchao Ma
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
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2
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Moxley B, Stevens W, Sneed J, Pearl C. Novel Diagnostic and Therapeutic Approaches to Temporomandibular Dysfunction: A Narrative Review. Life (Basel) 2023; 13:1808. [PMID: 37763212 PMCID: PMC10533154 DOI: 10.3390/life13091808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/19/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
Temporomandibular dysfunction (TMD) is a burgeoning area of study within the dental field. TMD is caused by abnormalities in the temporomandibular joint or muscles of mastication and can lead to pain, loss of function, and other complications. As this area of patient care receives increased focus, the ability to accurately diagnose TMD becomes paramount. The aim of this review is to summarize novel diagnostic and therapeutic techniques that have been proposed within the last approximately 3 years in order to inform readers of the cutting-edge advances in the field of TMD diagnosis and management, while also analyzing the clinical relevance of each study. A PubMed search was completed on 1 March 2023, using MeSH terms related to TMD diagnosis and treatment. The search yielded seven articles that pertained to the aim of this review article. The main findings from each study are summarized in this review article. These novel methods of diagnosing and treating TMD may improve our ability to assess and treat patients suffering from TMD.
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Affiliation(s)
- Brendan Moxley
- School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX 77054, USA; (W.S.); (J.S.)
| | - William Stevens
- School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX 77054, USA; (W.S.); (J.S.)
| | - Joel Sneed
- School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX 77054, USA; (W.S.); (J.S.)
| | - Craig Pearl
- Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston, Houston, TX 77054, USA;
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Zhang Y, Liu K, Shao Z, Lyu C, Zou D. The Effect of Asymmetrical Occlusion on Surface Electromyographic Activity in Subjects with a Chewing Side Preference: A Preliminary Study. Healthcare (Basel) 2023; 11:1718. [PMID: 37372836 DOI: 10.3390/healthcare11121718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
The relationship between asymmetrical occlusion and surface electromyographic activity (sEMG) in people with different chewing preferences is not clear. In this study, the 5 s sEMG changes in the masseter muscle (MM), sternocleidomastoid (SCM), lateral (LGA), and medial (MGA) gastrocnemius muscles were recorded in controls, and subjects with chewing side preference (CSP) during clench with bilateral (BCR), left (LCR), and right (RCR) posterior teeth placement of cotton rolls. The images of the middle 3 s were selected and expressed as the root mean square (unit: μV/s). The EMG waves of bilateral muscles were compared by computing the percentage overlapping coefficient (POC). Only the POCMM of the CSP showed gender differences at BCR and RCR. Between the control group and the CSP group, there were significant differences in the POCMM and the POCLGA at BCR. In addition, there was a significant difference in POCMM and POCSCM between the two populations in different occlusal positions. The change in the POCSCM correlated with the change in the POCMM (r = 0.415, p = 0.018). The experiment-induced asymmetrical occlusion showed that the altered symmetry of the MM correlated with the altered symmetry of the SCM. Long-term asymmetrical occlusion (i.e., CSP) not only affects MM but also has potential effects on other superficial muscles (e.g., LGA).
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Affiliation(s)
- Yubing Zhang
- Department of Stomatology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Kun Liu
- Department of Rehabilitation Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Zhengwei Shao
- Department of Stomatology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Chengqi Lyu
- Department of Stomatology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Derong Zou
- Department of Stomatology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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Yiu EML, Lau GWH, Wang F. Fatigue-Related Change in Surface Electromyographic Activities of the Perilaryngeal Muscles. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:98-109. [PMID: 36580552 DOI: 10.1044/2022_jslhr-22-00283] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE This study set out to quantify the fatigue-related changes in surface electromyographic (sEMG) activities of the perilaryngeal muscles following a vocal loading task. METHOD Thirty-six young healthy participants (M age = 22.4 years) with normal voice performed karaoke singing for at least 100 min. Before the singing task, all participants underwent the sEMG measure and completed a Perceived Vocal Fatigue Score (P-VFS) questionnaire. After the singing task, all participants were immediately measured with the P-VFS again. Half of the participants were then measured for their sEMG immediately after their karaoke singing task, and the other half were given 20 min of rest before undertaking the sEMG measure. The P-VFS and the median frequency (MDF) of the sEMG signals collected from the suprahyoid, infrahyoid, and sternocleidomastoid muscles before and after the singing task were compared using a linear mixed-effects model. RESULTS All participants reported a perceived vocal fatigue after singing, with a significantly increased P-VFS. Compared with the presinging baseline, the MDF of the sEMG signals in perilaryngeal muscles was significantly lower immediately after the singing task. Such a significant difference was also found after 20 min following the singing task. CONCLUSIONS The MDF analysis of the sEMG signals could identify and quantify the performance vocal fatigue contributed by perilaryngeal muscles following a vocal loading task. The findings also showed that such fatigue in perilaryngeal muscles, as far as sEMG activities are concerned, can last for at least 20 min.
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Affiliation(s)
- Edwin M-L Yiu
- Voice Research Laboratory, Faculty of Education, The University of Hong Kong, Pokfulam
| | - Gary W H Lau
- Voice Research Laboratory, Faculty of Education, The University of Hong Kong, Pokfulam
| | - Feifan Wang
- Voice Research Laboratory, Faculty of Education, The University of Hong Kong, Pokfulam
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Dicieri-Pereira B, Gomes MF, Giannasi LC, Nacif SR, Oliveira EF, Salgado MAC, de Oliveira Amorim JB, Oliveira W, Bressane A, de Mello Rode S. Down syndrome: orofacial pain, masticatory muscle hypotonia, and sleep disorders. Sleep 2022; 45:6652371. [DOI: 10.1093/sleep/zsac181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 07/13/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
The aim of the present study was to investigate orofacial pain in individuals with Down syndrome (DS) and determine possible associations with masticatory muscle hypotonia (MMH), maximum mouth opening (MMO), and sleep disorders. Twenty-three individuals with DS underwent a standardized clinical examination using Axis I of the Diagnostic Criteria for Temporomandibular Disorders, for the diagnosis of pain in the masseter and temporal muscles and temporomandibular joint (TMJ). MMH was investigated using electromyography of the temporal and masseter muscles and the measurement of maximum bite force (MBF). MMO was measured using an analog caliper. Sleep disorders (obstructive sleep apnea [OSA], snoring index [SI], and sleep bruxism index [SBI]) were investigated using type II polysomnography. Statistical analysis was performed. Nonsignificant differences were found in muscle and TMJ pain between the sexes. However, myalgia and referred myofascial pain in the left masseter muscle were more frequent in males (69%) than females (40%). Electrical activity of the temporal (left: p = .002; right: p = .004) and masseter (left: p = .008) muscles was significantly lower in males than in females. MBF range was lower in males than females, indicating the highest MMH among males. OSA, SI, and SBI were identified in both sexes, but with no statistically significant differences. We concluded that myalgia and referred myofascial pain were found in some individuals with DS, especially in males. Arthralgia was found mainly in females. Temporal and masseter myalgia may have exerted an influence on the severity of MMH in males, particularly on the left side.
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Affiliation(s)
- Bruna Dicieri-Pereira
- Center for Biosciences Applied to Patients with Special Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University (UNESP) , São Paulo , Brazil
| | - Monica Fernandes Gomes
- Center for Biosciences Applied to Patients with Special Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University (UNESP) , São Paulo , Brazil
| | - Lilian Chrystiane Giannasi
- Center for Biosciences Applied to Patients with Special Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University (UNESP) , São Paulo , Brazil
| | | | - Ezequiel Fernandes Oliveira
- Center for Biosciences Applied to Patients with Special Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University (UNESP) , São Paulo , Brazil
| | - Miguel Angel Castillo Salgado
- Center for Biosciences Applied to Patients with Special Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University (UNESP) , São Paulo , Brazil
| | - José Benedito de Oliveira Amorim
- Center for Biosciences Applied to Patients with Special Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University (UNESP) , São Paulo , Brazil
| | - Wagner Oliveira
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São José dos Campos Campus, São Paulo State University (UNESP) , São Paulo , Brazil
| | - Adriano Bressane
- Environmental engineering department, Institute of Science and Technology, São José dos Campos Campus, São Paulo State University (UNESP) , São Paulo , Brazil
| | - Sigmar de Mello Rode
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São José dos Campos Campus, São Paulo State University (UNESP) , São Paulo , Brazil
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Szyszka-Sommerfeld L, Sycińska-Dziarnowska M, Machoy M, Wilczyński S, Maglitto M, Cernera M, Spagnuolo G, Woźniak K. Electromyographic Study of Masticatory Muscle Function in Children with Down Syndrome. J Clin Med 2022; 11:jcm11030506. [PMID: 35159958 PMCID: PMC8837010 DOI: 10.3390/jcm11030506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/16/2022] [Accepted: 01/18/2022] [Indexed: 11/16/2022] Open
Abstract
This study assessed the electrical activity of the masticatory muscles in both children with down syndrome (DS) and healthy children. After applying the inclusion and exclusion criteria, 30 patients aged between 7.9 and 11.8 years participated in the study. They were divided into two groups of 15: DS and non-DS. A DAB-Bluetooth device (Zebris Medical GmbH, Germany) was used to record the electromyographical (EMG) activity of the right and left temporal and of the right and left masseter muscles at rest and during maximum voluntary clenching (MVC). The asymmetry index between right and left masticatory muscle EMG activity was calculated for each position. The Mann–Whitney U test was applied to analyze the study results. There were no differences in the electrical activity of the temporal and masseter muscles at rest between the groups. During MVC, the asymmetry index for the masseter muscles was significantly higher in subjects with DS. The electrical potentials of the temporal and masseter muscles in children with DS were significantly lower compared to the corresponding parameters for healthy children when clenching.
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Affiliation(s)
- Liliana Szyszka-Sommerfeld
- Department of Orthodontics, Pomeranian Medical University in Szczecin, Al. Powst. Wlkp. 72, 70111 Szczecin, Poland; (L.S.-S.); (M.S.-D.); (M.M.); (K.W.)
| | - Magdalena Sycińska-Dziarnowska
- Department of Orthodontics, Pomeranian Medical University in Szczecin, Al. Powst. Wlkp. 72, 70111 Szczecin, Poland; (L.S.-S.); (M.S.-D.); (M.M.); (K.W.)
| | - Monika Machoy
- Department of Orthodontics, Pomeranian Medical University in Szczecin, Al. Powst. Wlkp. 72, 70111 Szczecin, Poland; (L.S.-S.); (M.S.-D.); (M.M.); (K.W.)
| | - Sławomir Wilczyński
- Department of Basic Biomedical Science, Medical University of Silesia in Katowice, 3 Kasztanowa Street, 41200 Sosnowiec, Poland;
| | - Marzia Maglitto
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy; (M.M.); (M.C.)
| | - Mariangela Cernera
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy; (M.M.); (M.C.)
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy; (M.M.); (M.C.)
- Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, 119435 Moscow, Russia
- Correspondence:
| | - Krzysztof Woźniak
- Department of Orthodontics, Pomeranian Medical University in Szczecin, Al. Powst. Wlkp. 72, 70111 Szczecin, Poland; (L.S.-S.); (M.S.-D.); (M.M.); (K.W.)
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Novel Functional Indices of Masticatory Muscle Activity. J Clin Med 2021; 10:jcm10071440. [PMID: 33916147 PMCID: PMC8036463 DOI: 10.3390/jcm10071440] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/24/2021] [Accepted: 03/26/2021] [Indexed: 12/13/2022] Open
Abstract
The aim of the present study was to analyze novel functional indices of masticatory muscle activity and compare them to existing and commonly used indices in patients with temporomandibular disorders (TMDs) and healthy adults. Based on the Research Diagnostic Criteria for Temporomandibular Disorders, 78 adult women qualified for the study. Subjects were divided into two groups: diagnosed TMDs (n = 36; mean age: 23.4 ± 2.6 years) and healthy adults (n = 42; mean age: 22.4 ± 2.3 years). Measurements of the bioelectric activity of the temporalis anterior (TA), superficial masseter (MM), and anterior bellies of the digastric muscle (DA) were carried out using the BioEMG III ™. Functional Clenching (FCI) and Functional Opening (FOI) indices were obtained as the ratio of the difference between the mean muscle root mean square (RMS) potentials during functional activity, including clenching (CL) and opening (MMO), and mean muscle resting (REST) potentials. Next, based on FCI and FOI indices, the Functional Clenching Activity Index (FCAI), Functional Clenching Symmetry Index (FCSI), and Functional Opening Symmetry Index (FOSI) were obtained. The statistical analysis showed significant differences in activity index left-sided (AcIL) and Activity index both-sided (AcItot) between TMDs and healthy women during rest measurements. The significant differences between both groups were noted in terms of all Functional Clenching Indices except Functional Clenching Index for MM right-sided (FCIMM-R). In all analyzed FCI indices, the control group showed higher values compared to the TMDs. Moreover, a significant difference between TMDs and controls was observed within Functional Clenching Activity Index left-sided (FCAIL) (14.56 vs. −0.45, p = 0.01). Both functional indices, and asymmetry (AsI) and activity (AcI) indices seem to be reliable in assessing symmetry and activity within masticatory muscles. Further studies should be performed to verify the effectiveness and suitability of the assessment of masticatory muscles using functional indices.
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Gomes MF, Giannasi LC, Fillietaz-Bacigalupo E, de Mancilha GP, de Carvalho Silva GR, Soviero LD, da Silva GYS, Nazario LDM, Dutra MTDS, Silvestre PR, de Oliveira LVF, Nacif SR, de Oliveira EF, Serafim IM, Pereira BD, Greca AR, Goulart MDGV, Rode SDM, Tanaka MH, Koga-Ito CY, Amorim JBDO, Salgado MAC. Evaluation of the masticatory biomechanical function in Down syndrome and its Influence on sleep disorders, body adiposity and salivary parameters. J Oral Rehabil 2020; 47:1007-1022. [PMID: 32463923 DOI: 10.1111/joor.13023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 04/29/2020] [Accepted: 05/11/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the phenotypic features of the masticatory biomechanics in atypical subjects with Down syndrome (DS). Its influence was analysed on sleep disorders, body adiposity and its risks, and some physicochemical properties of saliva. METHODS Seventy subjects were enrolled to assess masticatory biomechanical function and divided into two groups: DS and control groups. Electrical activities of the masseter and temporal muscles (at rest and in maximum voluntary clench-MVC), maximum bite force-MBF and maximum mouth opening-MMO were investigated. Among the atypical subjects, just 24 participants underwent the anthropometry, the polysomnography II and the saliva testing (salivary flow rate-SFR, buffer capacity-BC and salivary cortisol levels, morning/SC-AM and night/SC-PM). RESULTS MVC and MBF values showed high statistical significance in the control group (P < .001) than in the DS group of 35. MMO values were slightly increased in the DS group in relation to the control group. Overweight and obesity were found in both genders. Atypical women showed higher risk to develop cardiovascular-metabolic diseases than in atypical men. OSA severe was 20% for atypical women and 42.8% for atypical men, whereas snoring index was present in all genders. SFR was reduced in 100% of atypical subjects (hyposalivation in 10% women and 28.5% men). Furthermore, 100% BC, 66.6% SC-AM and 91.6% SC-PM showed normal patterns. CONCLUSION Masseter and temporal muscle hypotonia was found in all atypical subjects with DS. This muscle dysfunction strongly was related to overweight/obesity, risks for development of cardiovascular/metabolic diseases, OSA severity, successive snoring episodes and salivary flow reduction in DS.
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Affiliation(s)
- Mônica Fernandes Gomes
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Lilian Chrystiane Giannasi
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Elaine Fillietaz-Bacigalupo
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Gabriela Pinto de Mancilha
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Gabriela Raine de Carvalho Silva
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Laura Dias Soviero
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Gabriella Yasmin Santos da Silva
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Letícia de Miguel Nazario
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Marignês Theotonio Dos Santos Dutra
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | | | | | | | | | - Irene Moreira Serafim
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Bruna Dicieri Pereira
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Amanda Reis Greca
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Maria das Graças Vilela Goulart
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Sigmar de Mello Rode
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | | | - Cristiane Yumi Koga-Ito
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - José Benedito de Oliveira Amorim
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Miguel Angel Castillo Salgado
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
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