Effects of Chewing Training on Orofacial and Cognitive Function in Healthy Individuals: A Systematic Review

Background: There is some evidence showing significant correlations between acute chewing gum and orofacial function, and between acute chewing gum and cognitive function; however, as far as we are aware, little is known about the chronic effects of chewing gum training on cognitive and orofacial functions in healthy adults. Objectives: To evaluate the chronic effects of chewing gum training on orofacial and cognitive functions in healthy adults. Method: Searches of the electronic databases PubMed, Scopus, BVS, CENTRAL, Scopus, and Google Scholar were conducted from inception to 14 January 2020. The inclusion criteria used were: clinical trial or randomized controlled trial lasting a minimum of four weeks, chewing gum intervention in at least one arm of the study, presence of a non-exercise control group, study population consisting of healthy adults, study outcomes consisting of orofacial function and/or cognitive function. Results: Starting from 5973 sources, a total of six articles met the inclusion criteria, and they were subjected to a systematic review. The main findings were that chewing gum training improved some variables related to orofacial function. No clear effect of chewing gum training on cognitive function was found. Conclusions: Chronic chewing gum training has an unclear positive effect on specific variables related to orofacial and cognitive function in healthy adults.

Automatic Facial Landmark Localization in Clinical Populations - Improving Model Performance with a Small Dataset

Background Automatic facial landmark localization in videos is an important first step in many computer vision applications, including the objective assessment of orofacial function. Convolutional neural networks (CNN) for facial landmarks localization are typically trained on faces of healthy and young adults, so model performance is inferior when applied to faces of older adults or people with diseases that affect facial movements, a phenomenon known as algorithmic bias. Fine-tuning pre-trained CNN models with representative data is a well-known technique used to reduce algorithmic bias and improve performance on clinical populations. However, the question of how much data is needed to properly fine-tune the model remains. Methods In this paper, we fine-tuned a popular CNN model for automatic facial landmarks localization using different number of manually annotated photographs from patients with facial palsy and evaluated the effects of the number of photographs used for model fine-tuning in the model performance by computing the normalized root mean squared error between the facial landmarks positions predicted by the model and those provided by manual annotators. Furthermore, we studied the effect of annotator bias by fine-tuning and evaluating the model with data provided by multiple annotators. Results Our results showed that fine-tuning the model with as little as 8 photographs from a single patient significantly improved the model performance on other individuals from the same clinical population, and that the best performance was achieved by fine-tuning the model with 320 photographs from 40 patients. Using more photographs for fine-tuning did not improve the model performance further. Regarding the annotator bias, we found that fine-tuning a CNN model with data from one annotator resulted in models biased against other annotators; our results also showed that this effect can be diminished by averaging data from multiple annotators. Conclusions It is possible to remove the algorithmic bias of a\textbf{depth} CNN model for automatic facial landmark localization using data from only 40 participants (total of 320 photographs). These results pave the way to future clinical applications of CNN models for the automatic assessment of orofacial function in different clinical populations, including patients with Parkinson’s disease and stroke.

Avaliação da intensidade de dor em pacientes submetdos à anestesia tópica com tetracaína e lidocaína, previamente à injeção de toxina botulínica

Aesthetic procedures are associated with improving of individual's self-esteem. The specialty of Orofacial Harmonization (HOF) in Dentistry makes it possible to treat patients' orofacial function and aesthetics. Through numerous procedures, the objective is to improve and correct individuals facial aspects. For this, it is necessary to use topical anesthetics prior to the procedures. The product must be potent, effective and safe. There are few options commercially available in Brazil, which leads to the fact that the professional has many times to manipulate the anesthetic for use. Thus, the present study aimed to clinically compare the performance of two topical anesthetics, one already commercialized in Brazil (lidocaine) and another manipulated (tetracaine). So, patients were asked to point out on a scale the intensity of pain felt after the injections. The data was tabulated and analyzed. Partial results show that 4% tetracaine topical anesthetic was more effective than lidocaine regarding pain control prior to botulinum toxin injections.

Temporomandibular disorders and Burnout syndrome in students of the eighth period of dentistry course

ABSTRACT Objective: To investigate the incidence of painful temporomandibular disorders (TMD) and Burnout Syndrome (BS) in Dentistry students, based on the subjective perception of signs and symptoms, and to verify if there is a coexistence relation between these conditions. Methods: 57 students (8th period of the dentistry course, 23 years mean age), 39 women and 18 men, responded to the Maslach Burnout Inventory Questionnaire – Students Survey (MBI-SS), ProTMDMulti and were evaluated for the presence of TMD diagnosis (DC/TMD). Results: The incidence of TMD was 22% and BS was 8.7%. Among the students with BS, 80% had a TMD diagnosis, as well as a greater subjective perception of TMD signs and symptoms and a longer duration of pain. They also showed higher scores of signs/symptoms perception for situations involving orofacial function. Conclusion: There seems to be a clinical coexistence between the BS and painful TMD in the studied sample, Dentistry students with BS and high scores on the MBI-SS are more likely to have painful TMD.

Evidence of orofacial myofunctional therapy patients with asthma and rhinitis: a systematic review

ABSTRACT Purpose to evaluate the efficacy of orofacial myofunctional therapy in improving orofacial function and nasal breathing in patients with asthma and rhinitis and, consequently, achieve clinical control of these conditions. Research strategies We used the elements of the PICOT method (study population, intervention, comparison, outcomes and type of studies) to define the eligibility criteria: (1) Population: patients with asthma and rhinitis; (2) Intervention: orofacial myofunctional therapy to improve chewing, swallowing, and breathing; (3) Comparison: control group without orofacial myofunctional therapy; (4) Predefined outcomes: clinical control of asthma and improvement of orofacial functions and nasal breathing; (5) Study type: clinical trials. The data were collected from PubMed, SCOPUS, Web of Science, Science Direct, LILACS, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL), OATD, and Open Thesis, in November 2018. Selection criteria Randomized controlled trials published in full-text versions without language restriction, no filter was used. Data analysis Demographic characteristics of study participants, specific diagnosis of asthma and control medication, type, duration, intensity and follow-up of orofacial myofunctional therapy, and outcome data. The risk of bias was assessed according to the Cochrane guidelines for clinical trials. Results One study met the eligibility criteria: although the study has shown an improvement of functional control and clinical scores of asthma, the evidence is very low. Conclusion There is no scientific evidence on the efficacy of orofacial myofunctional therapy in improving clinical control, orofacial function, and nasal breathing in patients with asthma and rhinitis.

Orofacial Function, Articulation Proficiency, and Intelligibility in 5-Year-Old Children Born With Cleft Lip and Palate

Objective: To explore and describe orofacial function in 5-year-old children born with clefts affecting the palate and to investigate potential relationship with articulation proficiency and intelligibility. Design: A prospective cohort study of 88 consecutive patients born with cleft lip and palate (CLP) between July 2009 and June 2011. Participants: Excluding internationally adopted children and children with no speech production resulted in 52 children with different cleft types and additional malformations, examined at age 5. Data on orofacial function were available for 43 children. Outcome Measures: Screening of orofacial function resulted in a profile and a total score, narrow phonetic transcription of test consonants produced a percentage of consonants correct (PCC) score, and ratings of intelligibility by speech and language pathologists (SLPs) and by parents gave 2 estimates. Inter- and intra-transcriber agreement was calculated. Results: Orofacial dysfunction was found in 37% of children, with results not significantly different between cleft types but significantly more frequent than in children born without CLP. Age-appropriate articulation proficiency was found in 39%, 49% presented below −2 standard deviations. Just above 50% had good intelligibility and were always understood by different communication partners according to both SLP and parent ratings. No significant correlation was found between orofacial dysfunction and PCC or intelligibility. Conclusions: Orofacial dysfunction was not found to be an explanatory factor for speech outcome in children born with CLP.

Effects of an Oral-Pharyngeal Motor Training Programme on Children with Obstructive Sleep Apnea Syndrome in Hong Kong: A Retrospective Pilot Study

Background This study aimed to investigate the effects of an oropharyngeal motor training programme on children with Obstructive Sleep Apnea Syndrome (OSAS) in Hong Kong. Methods In this retrospective study, we reviewed the outcomes of 10 children with OSAS who had received an oropharyngeal motor training programme in Occupational Therapy Department of an acute hospital in Hong Kong over a 1-year programme. Each participant attended an individual oropharyngeal motor training programme plus a follow-up session after 2 months. The training programme consisted of 10 individual mobilization exercises involving the orofacial and pharyngeal area for 45 minutes. Each exercise had to be repeated for 10 times. Three outcome measures were chosen to study the effectiveness of the training programme including tongue strength, tongue endurance level and orofacial function. Tongue strength and tongue endurance level were assessed using the Iowa Oral Pressure Instrument (IOPI). The Nordic Orofacial Test-Screening (NOT-S) Assessment was used to assess the orofacial function. Seven out of 10 participants completed the training programme and attended the follow-up session after two months. Results The tongue strength and the scores of NOT-S of the 7 participants were found to have significant improvement after training. However, there was no significant difference in tongue endurance level. Conclusion The findings of this study support the role of occupational therapist in oromotor training modalities to improve the respiratory function for children with OSAS in Hong Kong. Copyright © 2017, Hong Kong Occupational Therapy Association. Published by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ).