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      Programa de terapia miofuncional orofacial para indivíduos submetidos à cirurgia ortognática Translated title: Orofacial myofunctional therapy program for individuals undergoing orthognathic surgery

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          Abstract

          RESUMO Objetivo: apresentar um Programa de Terapia Miofuncional Orofacial para indivíduos submetidos à cirurgia ortognática. Métodos: foram realizadas 3 etapas distintas: a primeira envolveu a elaboração do programa inicial a partir da revisão da literatura sobre o processo terapêutico após a cirurgia; a segunda a aplicação do programa inicial por duas fonoaudiólogas especialistas em motricidade orofacial em 21 indivíduos, após ortognática, que sugeriram modificações no protocolo inicial, resultando numa segunda versão; na terceira e última etapa, o mesmo foi analisado quanto ao conteúdo por três fonoaudiólogas especialistas em Motricidade Orofacial e novas modificações foram realizadas. Resultado: o programa foi elaborado com base em 38 trabalhos científicos, cuja aplicação pelas fonoaudiólogas resultou em modificações considerando a tipologia facial e as condições dento-oclusais, armazenamento do soro fisiológico; detalhamento dos objetivos das atividades propostas e alongamento do lábio superior. Após as sugestões das especialistas a versão final foi constituída de 12 sessões, sendo a primeira avaliação, 10 sessões de terapia uma vez por semana, envolvendo exercícios miofuncionais, estimulação sensorial e treino funcional, sendo a última sessão de reavaliação. Conclusão: foi possível desenvolver um Programa de Terapia Miofuncional Orofacial para indivíduos submetidos à cirurgia ortognática, sendo necessário que o mesmo seja validado.

          Translated abstract

          ABSTRACT Purpose: to present an Orofacial Myofunctional Therapy Program for individuals submitted to orthognathic surgery. Methods: 3 different steps were performed: the first involved preparation of the initial program, by reviewing the literature on the therapeutic process after surgery; the second comprised the application of the initial program by two speech therapists qualified in orofacial motricity, to 21 individuals, after orthognathic surgery, who suggested changes in the initial protocol, resulting in a second version; on the third and last stage, the content of the Therapy Program was analyzed regarding the content, by three speech therapists specialists in Orofacial Motricity and further changes were made. Results: the Therapy Program was developed based on 38 scientific papers, whose application by the speech therapists resulted in changes, taking into account the facial typology and dento-occlusal conditions, storage of saline, detailing of the goals of proposed activities and elongation of the upper lip. After the experts’ suggestions, the final version consisted of 12 sessions, the first being assessment, 10 sessions of therapy once a week, involving myofunctional exercises, sensorial stimulation and functional training, and the last session for re-assessment. Conclusion: it was possible to develop a Myofunctional Orofacial Therapy Program aimed at individuals submitted to orthognathic surgery, to be validated in future studies.

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          Sobre confiabillidade e validade

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            Protocol of orofacial myofunctional evaluation with scores.

            In the literature there is no validated instrument for the clinical evaluation of the orofacial myofunctional condition of children that will permit the examiner to express numerically his perception of the characteristics and behaviors observed. The proposal of this study is to describe a protocol for the evaluation of children aged 6-12 years in order to establish relations between the orofacial myofunctional conditions and numerical scales. The protocol validity, reliability of the examiners and agreement between them was analyzed. Eighty children aged 6-12 years participated in the study. All were evaluated and 30 were selected at random for the analyses (age range: 72-149 months, mean=103.3, S.D.=23.57). Individuals with and without orofacial myofunctional disorders were included. The examiners were two speech therapists properly calibrated in orofacial myofunctional evaluation. Two protocols were constructed. One, based on traditional models, was called traditional orofacial myofunctional evaluation (TOME), and the other, with the addition of numerical scales, was called orofacial myofunctional evaluation with scores (OMES). The clinical conditions included were: appearance, posture and mobility of lips, tongue, cheeks and jaws, respiration, mastication and deglutition. Statistical analysis was performed using the split-half reliability method. Means, standard deviations and the Spearman correlation coefficient were also calculated. There was a statistically significant correlation between the evaluations of 30 children assessed with the TOME and OMES protocols (r=0.85, p<0.01). The reliability between protocols was 0.92. The test-retest reliability of the OMES instrument was 0.99 and the correlation was 0.98. Reliability between examiners 1 and 2 using the OMES protocol was 0.99, and the correlation was 0.98 (p<0.01). The OMES protocol proved to be a valid and reliable instrument for orofacial myofunctional evaluation, permitting the grading of orofacial myofunctional conditions within the limits of the selected items.
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              Expanded protocol of orofacial myofunctional evaluation with scores: Validity and reliability.

              Clinical evaluation of the stomatognathic system is indispensable for the diagnosis of orofacial myofunctional disorders. In order to obtain a more precise diagnosis, the protocol of orofacial myofunctional evaluation with scores (OMES protocol) (Int. J. Pediatr. Otorhinolaryngol. 72 (2008) 367-375) was expanded in terms of number of items and scale amplitude. The proposal of this study is to describe the expanded OMES protocol (OMES-E) for the evaluation of children. Validity of the protocol, reliability of the examiners and agreement between them were analyzed, as also were the sensitivity, specificity and predictive values of the instrument.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                rcefac
                Revista CEFAC
                Rev. CEFAC
                ABRAMO Associação Brasileira de Motricidade Orofacial (São Paulo, SP, Brazil )
                1982-0216
                March 2017
                : 19
                : 2
                : 277-288
                Affiliations
                [2] Bauru orgnameUniversidade de São Paulo orgdiv1Faculdade de Odontologia de Bauru orgdiv2Departamento de Fonoaudiologia Brazil
                [1] Bauru orgnameUniversidade de São Paulo orgdiv1Faculdade de Odontologia de Bauru Brazil
                Article
                S1516-18462017000200277
                10.1590/1982-021620171921317
                86f5b434-ddcd-4939-b9d6-d12b61a414b5

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 26 January 2017
                : 20 March 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 40, Pages: 12
                Product

                SciELO Brazil


                Terapia Miofuncional,Cirurgia Ortognática,Fonoaudiologia,Myofunctional Therapy,Orthognathic Surgery,Speech, Language and Hearing Sciences

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