Effect of spastic cerebral palsy on jaw-closing muscles during clenching

Santos, Maria Teresa Botti Rodrigues; Manzano, Felipe Scalco; Chamlian, Therezinha Rosane; Masiero, Danilo; Jardim, José Roberto

doi:10.1111/j.1754-4505.2010.00143.x

Cited by 14 publications

(10 citation statements)

References 15 publications

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“…According to the American Academy of Pediatric Dentistry, they show a moderate risk of caries 15 . Dental caries in individuals with CP could be also related to intellectual disability 4 , oromotor dysfunction 8,16 , the regular use of sugary anticonvulsant drugs 17 , shorter mastication endurance time 18 , biting reflexes 9 and worse quality of life and continual burden on the caregivers 5,8 , which can further influence oral hygiene 8 . Despite presenting those risk factors, it may be observed that since the individuals with CP are under a continuous preventive follow-up dental care, caries experience can be controlled.…”

Section: Discussionmentioning

confidence: 99%

Does the classification of cerebral palsy influence caries experience in children and adolescents?

Diniz¹,

Guaré²,

Ferreira³

et al. 2015

Braz. J. Oral Sci.

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Aim: To evaluate the influence of the classification of cerebral palsy (CP) on the caries experience in children and adolescents, and determine the types of teeth most affected by dental caries. Methods: A total of 181 individuals with CP, aged 8.30±4.10 years were examined for dental caries diagnosis in primary, mixed and permanent dentitions. The sample consisted of 96 quadriplegic individuals, 56 diplegic, 18 hemiplegic and 11 with choreoathetosis. The groups were compared using Kruskal-Wallis and Chi-square tests. Univariate logistic regression models were used to identify whether age was a predictor of caries risk (α=5%). Results: The sample was homogeneous as regards sex and age, among patients with quadriplegia, diplegia, hemiplegia and choreoathetosis. Out of the total sample, 51.4% of the individuals were caries free. The overall mean for the dmft and DMFT indices were 1.70±3.30 and 0.70±1.60, respectively. The mean caries experience in primary, mixed and permanent dentitions did not vary significantly according to the CP classification (p>0.05). Child´s age was a predictor for dental caries experience (p<0.05). Conclusions: The CP classification did not influence on caries experience, and the teeth most affected by dental caries were the primary and first permanent molars.

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Section: Discussionmentioning

confidence: 99%

Does the classification of cerebral palsy influence caries experience in children and adolescents?

Diniz¹,

Guaré²,

Ferreira³

et al. 2015

Braz. J. Oral Sci.

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“…The intensity of the current was chosen during the session based on the volunteer’s sensitivity. Maximum intensity reached ranged from 12 to 19 mA, which is very different from the intensity supported by the tibialis muscle (range: 28 to 44 mA) [ 30 ].…”

Section: Methodsmentioning

confidence: 99%

Effects of Neuromuscular Electrical Stimulation on the Masticatory Muscles and Physiologic Sleep Variables in Adults with Cerebral Palsy: A Novel Therapeutic Approach

et al. 2015

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Cerebral palsy (CP) is a term employed to define a group of non-progressive neuromotor disorders caused by damage to the immature or developing brain, with consequent limitations regarding movement and posture. CP may impair orapharygeal muscle tone, leading to a compromised chewing function and to sleep disorders (such as obstructive sleep apnea). Thirteen adults with CP underwent bilateral masseter and temporalis neuromuscular electrical stimulation (NMES) therapy. The effects on the masticatory muscles and sleep variables were evaluated using electromyography (EMG) and polysomnography (PSG), respectively, prior and after 2 months of NMES. EMG consisted of 3 tests in different positions: rest, mouth opening and maximum clenching effort (MCE). EMG values in the rest position were 100% higher than values recorded prior to therapy for all muscles analyzed (p < 0.05); mean mouth opening increased from 38.0 ± 8.0 to 44.0 ± 10.0 cm (p = 0.03). A significant difference in MCE was found only for the right masseter. PSG revealed an improved in the AHI from 7.2±7.0/h to 2.3±1.5/h (p < 0.05); total sleep time improved from 185 min to 250 min (p = 0.04) and minimun SaO2 improved from 83.6 ± 3.0 to 86.4 ± 4.0 (p = 0.04). NMES performed over a two-month period led to improvements in the electrical activity of the masticatory muscles at rest, mouth opening, isometric contraction and sleep variables, including the elimination of obstructive sleep apnea events in patients with CP.Trial RegistrationReBEC RBR994XFS http://www.ensaiosclinicos.gov.br

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“…It is the most common cause of severe physical disability in childhood (1), with an estimated prevalence of 2.4 per 1000 children (2). Individuals with CP present a high prevalence of dental caries (3)(4)(5)(6)(7), oral motor dysfunction (8), shorter mastication endurance time (9), biting reflexes (10), regular use of sugary anticonvulsant drugs (11), intellectual disability (12) and worse quality of life and continual burden on their caregivers (4) that can further influence oral hygiene (8). Moreover, a reduction in salivary flow and pH, compromise of the buffer capacity (13), changes in enzyme activity and sialic acid concentration (14) have been reported.…”

Section: Introductionmentioning

confidence: 99%

A controlled study comparing salivary osmolality, caries experience and caries risk in patients with cerebral palsy

Ruiz¹,

Diniz²,

Siqueira³

et al. 2017

JORDI - Journal of Oral Diagnosis

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Background: Cerebral palsy (CP) is a permanent neurological disorder accompanied by secondary musculoskeletal masticatory disorder, with repercussion on chewing and deglutition functions. In these conditions, the liquids ingestion is compromised resulting in salivary osmolality alteration. The objective of this study was to compare salivary osmolality, caries experience and caries risk between normoreactive individuals and patients with CP. Material and Methods: The participants were 4-20 years old: 52 patients with CP treated at a reference rehabilitation centre (study group, SG), and 52 normoreactive individuals (control group, CG). Saliva was collected for five minutes using cotton rolls. Following centrifugation, salivary osmolality was determined by freezing point depression osmometry. Evaluations included caries experience (DMFT index), and caries risk based on a caries-risk assessment tool (CAT). Descriptive and inferential statistics (Chi square and Student t tests) were used to compare the groups. Receiver operating characteristic (ROC) analyses were performed and the area under the ROC curve (Az) was calculated. The level of significance was set at 5%. Results: The groups were homogeneous for sex (p=0.843) and age (p=0.128). In the SG, spastic type CP was the most prevalent (80.8%), and patients showed significantly higher salivary osmolality values compared with the CG (p<0.001). No significant differences in caries experience (p=0.159) or caries risk (p=0.297) were observed. ROC curve analysis determined a salivary osmolality cutoff point of >74 for the SG and >54 for the CG in the presence of dental caries. A significant correlation was verified between salivary osmolality and the DMFT index for the SG (p≤0.05). Conclusions: Although patients with CP showed higher salivary osmolality values, higher caries experience and caries risk were not observed compared with normoreactive individuals.

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Effect of spastic cerebral palsy on jaw-closing muscles during clenching

Cited by 14 publications

References 15 publications

Does the classification of cerebral palsy influence caries experience in children and adolescents?

Does the classification of cerebral palsy influence caries experience in children and adolescents?

Effects of Neuromuscular Electrical Stimulation on the Masticatory Muscles and Physiologic Sleep Variables in Adults with Cerebral Palsy: A Novel Therapeutic Approach

A controlled study comparing salivary osmolality, caries experience and caries risk in patients with cerebral palsy

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