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      IMPACTO DE LAS PRÓTESIS REMOVIBLES EN LA POSICIÓN LINGUAL, PATRÓN DE DEGLUCIÓN Y CALIBRE SAGITAL DE LA VÍA AÉREA OROFARÍNGEA Translated title: THE IMPACT OF REMOVABLE PROSTHESIS ON THE POSITION OF THE TONGUE DURING RESTING AND SWALLOWING STATES, AND ON THE SAGITTAL SIZE OF THE OROPHARYNGEAL AIRWAY

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          Abstract

          INTRODUCCIÓN: las prótesis dentales removibles y su influencia en las praxis linguales, no han sido analizadas clínica y radiográficamente. El objetivo fue determinar si las prótesis removibles causan modificaciones clínicas en la posición lingual y en el patrón de deglución; y cambios radiográficos en el calibre sagital de la vía aérea orofaríngea en pacientes con pérdida de mesa molar. MÉTODOS: mediante un diseño preexperimental preprueba posprueba en un solo grupo, se evaluaron 15 pacientes en tres tiempos distintos: pretratamiento (T1), inmediatamente al insertar las prótesis (T2) y a los 6 meses posteriores (T3). La posición lingual se evaluó según Kotsiomiti. El patrón de deglución se evaluó según Bossart. Se hizo el análisis cefalométrico basado en Delaire y Argandoña para medir la vía área orofaríngea. Los datos clínicos fueron analizados estadísticamente con la prueba de Friedman, para la cefalometría se usó el análisis de varianza (ANOVA) y la prueba de Duncan. (p > 0,05) RESULTADOS: se encontraron diferencias altamente significativas en la posición lingual, variando desde la posición anormal superior a la normal inferior. En el patrón de deglución se encontraron diferencias significativas, variando del linguo-mandibular al linguo-dentario. El calibre sagital de la vía aérea orofaríngea disminuyó significativamente entre T1 y T2. CONCLUSIONES: clínicamente ocurren cambios positivos en la posición lingual en reposo y en el patrón de deglución. Los cambios negativos que ocurren en la vía aérea orofaríngea al insertar las prótesis tienden a revertirse a los 6 meses de uso, producto de la acomodación estructural y funcional del macizo lingual.

          Translated abstract

          INTRODUCTION: removable dentures and their influence on lingual position have not been clinically and radiographically tested. The objective of this study was to determine whether dentures cause clinical changes in tongue position and swallowing patterns, as well as radiographic changes in the sagittal caliber of the oropharyngeal airway in patients with molar table loss. METHODS: by means of a pretest-posttest preexperimental design in a single group, 15 patients were evaluated at three different times: pretreatment (T1), immediately after inserting the prosthesis (T2) and 6 months afterwards (T3). Lingual position was evaluated according to Kotsiomiti. Swallowing patterns were assessed according to Bossart. The cephalometric analysis by Delaire and Argandoña was conducted in order to measure the oropharyngeal airway. The clinical data were statistically analyzed by using the Friedman test, and for cephalometry both the variance analysis test (ANOVA) and Duncan test were used (p > 0.05). RESULTS: highly significant differences were found in tongue position, ranging from upper abnormal position to lower normal position. In terms of swallowing pattern, significant differences were found, ranging from lingual-mandibular to lingual-dental. The sagittal caliber of oropharyngeal airway significantly decreased between T1 and T2. CONCLUSIONS: clinically, positive changes occur in tongue position at rest and in swallowing pattern. Negative changes in the oropharyngeal airway after inserting dentures tend to revert within 6 months of use as a consequence of the structural and functional accommodation of the tongue mass.

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          Most cited references34

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          An analysis of different approaches to the assessment of upper airway morphology: a CBCT study.

          Upper airway morphology and respiration have been assigned an important role in the development of the craniofacial complex. Several studies advocate lateral cephalograms to evaluate the upper airway. Although this method has been widely used, a two-dimensional projection of a three-dimensional anatomical structure is questionable. To correlate linear measurements (sagittal and transversal), cross-sectional areas, and volumes of the upper airway determined on Cone Beam CT (CBCT) data sets. CBCT-scans of 34 patients were used to perform a 3D evaluation of the upper airway. Linear sagittal measurements reproducing those usually performed on lateral cephalograms, linear transversal measurements, cross-sectional areas, partial and total volumes (TV) were computed. The analysis showed a weak correlation (r 0.9) with sagittal measurement and with area. The upper part of the velopharynx presented a good correlation (0.8 < r < 0.9) between area and volume. Good correlation between most transversal measurements and the corresponding areas was found. Minimal sagittal, minimal transversal, and minimal area were weakly correlated with TV. Upper airway cannot be accurately expressed by single linear measurements as performed on cephalograms. The TV alone does not depict the morphology of the airway. A CBCT-based 3D analysis gives a better picture of the anatomical characteristics of the upper airways and therefore can lead to an improvement of the diagnosis.
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            Estadística aplicada

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              The functional matrix hypothesis revisited. 4. The epigenetic antithesis and the resolving synthesis.

              In two interrelated articles, the current revision of the functional matrix hypothesis extends to a reconsideration of the relative roles of genomic and of epigenetic processes and mechanisms in the regulation (control, causation) of craniofacial growth and development. The dialectical method was chosen to analyze this matter, because it explicitly provides for the fuller presentation of a genomic thesis, an epigenetic antithesis, and a resolving synthesis. The later two are presented here, where the synthesis suggests that both genomic and epigenetic factors are necessary causes, that neither alone is also a sufficient cause, and that only the two, interacting together, furnish both the necessary and sufficient cause(s) of ontogenesis. This article also provides a comprehensive bibliography that introduces the several new, and still evolving, disciplines that may provide alternative viewpoints capable of resolving this continuing controversy; repetition of the present theoretical bases for the arguments on both sides of these questions seems nonproductive. In their place, it is suggested that the group of disciplines, broadly termed Complexity, would most likely amply repay deeper consideration and application in the study of ontogenesis.

                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rfoua
                Revista Facultad de Odontología Universidad de Antioquia
                Rev Fac Odontol Univ Antioq
                Universidad de Antioquia (Medellín )
                0121-246X
                June 2013
                : 24
                : 2
                : 243-257
                Affiliations
                [1 ] Universidad Finis Terrae Chile
                [2 ] Universidad Finis Terrae Chile
                [3 ] Universidad Finis Terrae Chile
                [4 ] Universidad Finis Terrae Chile
                Article
                S0121-246X2013000100006
                5e54770d-9e92-41a7-affa-03ade1bd7b65

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Colombia

                Self URI (journal page): http://www.scielo.org.co/scielo.php?script=sci_serial&pid=0121-246X&lng=en
                Categories
                DENTISTRY, ORAL SURGERY & MEDICINE

                Dentistry
                complete denture,removable partial dentures,tongue,oropharynx,cephalometry,dentadura completa,dentadura parcial removible,lengua,orofarínge,cefalometría

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