Oral motor assessment in individuals with Moebius syndrome

Chewing skills in two and three year old children: Gender and age comparisons on an adapted version of the test of mastication and swallowing (TOMASS-C)

PURPOSE

Few assessment tools objectively measure chewing skills in the paediatric population. There is a need for assessment tools that use consistent foods so comparisons can be made between typically developing children and children with paediatric feeding disorders, and to measure the efficacy of treatment. The Test of Masticating and Swallowing Solids for adults (TOMASS) and children (TOMASS-C) are assessments that use a cracker as a consistent measure to assess chewing skills. Normative data exist for children over 4 years, however, no data are available for younger children. This study investigated age and gender-related differences in mastication skills in typically developing children aged 2-3 years when eating a cracker.

METHOD

Thirty participants aged 2;0-3;10 were assessed using an adapted version of the TOMASS-C. Participants were required to eat a single Arnott's Salada cracker, and the number of bites, masticatory cycles, swallows, and duration of time to finish the cracker were measured.

RESULT

Two-year-old children used more masticatory cycles and took longer to finish the cracker than 3-year-old children. There were no significant effects of age on the number of swallows and number of bites, and no significant differences between boys and girls.

CONCLUSION

This study provides preliminary normative data for chewing skills in children aged 2 and 3 years and confirms that the TOMASS-C is sensitive to developmental changes in mastication within this younger age range. These results expand our understanding of oral motor and chewing development in children.

Dental management of a patient with Moebius syndrome: A case report

BACKGROUND

Moebius syndrome (MBS) is a nonprogressive and rare congenital neuromuscular disorder involving the facial nerve and abductor nerve; it mainly manifests as facial paralysis and eye strabismus paralytic symptoms. Tissues in the oral cavity are also compromised, characterized by microstomia, micrognathia, tongue malformation, cleft lip, high arched palate or cleft palate, bifid uvula, and dental malocclusion. Therefore, dentistry plays a fundamental and crucial role in caring for these individuals. However, there is limited available data on MBS treatment, particularly regarding dental management.

CASE SUMMARY

This case report presents dental treatment of a 21-year-old man with MBS and discusses crucial interactions among oral complications of MBS. In this case, the patient was clinically characterized by congenital neuromuscular disorder, occlusal disorders, and tooth and gum problems. It is noteworthy that the patient presented early eruption of deciduous teeth 2 mo after birth, which has not been reported in other MBS cases and suggests a potentially new clinical manifestation of this syndrome. It is important to note that MBS cannot be cured, and oral manifestations of this syndrome can be managed by a multidisciplinary health care team that helps the patient maintain oral hygiene and dental health. After a series of oral treatments, no obvious poor oral hygiene, swollen gums, or abnormal imaging results were observed after 2 years of follow-up.

CONCLUSION

This case addressed the oral clinical manifestations of MBS and difficulties experienced during dental management, and suggested early tooth eruption as a potentially new clinical manifestation of this syndrome. Knowledge of the loop-mediated association among oral complications of this syndrome is essential to perfecting treatments.

Psychometric properties of the Persian version of the oral motor assessment scale in children and adolescents with cerebral palsy

The Oral Motor Assessment Scale (OMAS) is a diagnostic tool used to assess the oral motor skills in individuals with neurological and neuromuscular disorders. This assessment was developed by Brazilian researchers and for the first time, its validity and reliability was examined in Brazil. The purpose of the present study was to examine the validity and reliability of the adopted Persian version of the OMAS (OMAS-P) to assess the oral skills of Iranian individuals with cerebral palsy (CP). In this non-experimental descriptive-analytical study 120 people (60 children and adolescents with CP) aged 3 to 15 years and 60 healthy subjects) participated. The research was carried out in number of stages including translation and adaptation of the OMAS to Persian (OMAS-P) in a forward-backward way. The oral motor skills functionality of the 120 people was examined using the OMAS-P. To assess the repeatability and reliability of the OMAS-P the assessments was repeated on the participants with CP disorder after two weeks. Results corresponding to this study indicated a reasonable agreement (Kappa >0.7) for all the OMAS-P items. The mean values of the OMAS-P items were appreciably different between the two groups (p < 0.001). The Persian version of the OMAS (OMAS-P) indicated consistent psychometric properties and can be used as a reliable tool for oral motor skills assessment in people with CP. However, it seems that by specifying factors such as the time frame for the OMAS, the position of the child during assessment, and whether or not parents use facilitating techniques, the comprehensiveness and efficiency of the OMAS data will also upgrade.

Upper Lip Horizontal Line: Characteristics of a Dynamic Facial Line

Background: Upper lip appearance received major attention with the introduction of diverse treatment modalities, including lip augmentation, rhinoplasty surgery, and dental treatment designed to support the upper lip. Our objectives were to define the prevalence and characteristics of the upper lip horizontal line (ULHL), which is a dynamic line appearing during a smile, in relation to gender, malocclusions, aging, and facial morphology. Methods: First, the prevalence and gender distribution of ULHL was examined from standardized en-face imaging at full smile of 643 randomly selected patients. Second, cephalometric and dental cast model analyses were made for 97 consecutive patients divided into three age groups. Results: ULHL appears in 13.8% of the population examined, and prevailed significantly more in females (78%). The prevalence of ULHL was not related to age nor to malocclusion. Patients presenting ULHL showed shorter upper lip and deeper lip sulcus. The skeletal pattern showed longer mid-face, shorter lower facial height and greater prevalence of a gummy smile. Conclusions: Female patients with short upper lip, concavity of the upper lip, and gummy smile are more likely to exhibit ULHL. The ULHL is not age-related and can be identified in children and young adults. Therefore, it should be considered when selecting diverse treatment modalities involving the upper lip.

Labial Incompetence in Mobius Syndrome: LeFort I Impaction Case Report and Review of Management Strategies

Difficulty with speech intelligibility in Mobius syndrome patients due to bilabial incompetence is common yet rarely discussed. We present a patient with Mobius syndrome who underwent counterclockwise LeFort I impaction to improve her labial competence. In addition, we present a literature review of management strategies for labial incompetence correction in Mobius patients. At 7-year follow-up after LeFort 1 impaction, the patient reports improvement in speech intelligibility, specifically regarding the ability to pronounce bilabial consonants. This is the first published report of LeFort I impaction to improve labial competence and bilabial consonant pronunciation in a Mobius syndrome patient.

Salivary parameters and oral health in the Moebius syndrome

PURPOSE

To evaluate salivary characteristics, such as flow rate, buffering capacity and amylase activity, and associate these parameters with oral health in individuals with Moebius syndrome (MS) and controls.

METHODS

The researchers assessed caries (ICDAS), periodontal disease (PSR), and plaque (Silness Löe) indexes in both groups. Unstimulated, stimulated, and bilateral parotid saliva were also collected. The salivary flow (milliliters/minute) and α-amylase activity were measured in all samples. The α-amylase activity was determined by maltose production. The buffering capacity was measured in stimulated saliva by titration of 0.01N HCl.

RESULTS

The occurrence of carious lesions, related to cut-off 2, as well as the occurrence of periodontal disease, was significantly higher (p > 0.05) in participants with MS when compared to the control group. Also, MS individuals presented decreased salivary flow, decreased buffering capacity, and amylase activity.

CONCLUSIONS

MS individuals present salivary alterations, which can be related to higher risk for caries.