INTRODUCTION: Mouth breathing (MB) is an etiological factor for sleep-disordered breathing (SDB) during childhood. The habit of breathing through the mouth may be perpetuated even after airway clearance. Both habit and obstruction may cause facial muscle imbalance and craniofacial changes. OBJECTIVE: The aim of this paper is to propose and test guidelines for clinical recognition of MB and some predisposing factors for SDB in children. METHODS: Semi-structured interviews were conducted with 110 orthodontists regarding their procedures for clinical evaluation of MB and their knowledge about SDB during childhood. Thereafter, based on their answers, guidelines were developed and tested in 687 children aged between 6 and 12 years old and attending elementary schools. RESULTS: There was no standardization for clinical recognition of MB among orthodontists. The most common procedures performed were inefficient to recognize differences between MB by habit or obstruction. CONCLUSIONS: The guidelines proposed herein facilitate clinical recognition of MB, help clinicians to differentiate between habit and obstruction, suggest the most appropriate treatment for each case, and avoid maintenance of mouth breathing patterns during adulthood.

INTRODUCTION: The main cause of mouth breathing and sleep-disordered breathing (SDB) in childhood is associated with upper airway narrowing to varying degrees. OBJECTIVE: The aim of this study was to assess the prevalence of morphological and functional craniofacial changes and the main clinical symptoms of SDB in healthy children. METHODS: A cross-sectional observational study was conducted. A sample comprising 687 healthy schoolchildren, aged 7-12 years old and attending public schools, was assessed by medical history, clinical medical and dental examination, and respiratory tests. The self-perceived quality of life of mouth breathing children was obtained by a validated questionnaire. RESULTS: Out of the total sample, 520 children were nose breathers (NB) while 167 (24.3%) were mouth breathers (MB); 32.5% had severe hypertrophy of the palatine tonsils, 18% had a Mallampati score of III or IV, 26.1% had excessive overjet and 17.7% had anterior open bite malocclusion. Among the MB, 53.9% had atresic palate, 35.9% had lip incompetence, 33.5% reported sleepiness during the day, 32.2% often sneezed, 32.2% had a stuffy nose, 19.6% snored, and 9.4% reported having the feeling to stop breathing while asleep. However, the self-perception of their quality of life was considered good. CONCLUSION: High prevalence of facial changes as well as signs and symptoms of mouth breathing were found among health children, requiring early diagnosis and treatment to reduce the risk of SDB.

Introdução: A respiração bucal ocasiona adaptações físicas e comportamentais que interferem na qualidade de vida infantil. Objetivo: Associar as adaptações craniofaciais e da articulação temporomandibular (ATM) à qualidade de vida de escolares respiradores bucais (RB). Métodos: Estudo transversal em RB (n = 73) do ensino fundamental, entre 7 e 14 anos. Fisioterapeutas avaliaram a ATM e a postura craniocervical por meio de exames clínicos e da biofotogrametria, respectivamente. Posteriormente, fisioterapeutas aplicaram questões relacionadas à alimentação, à escolaridade e ao sono desses indivíduos. Estatística: Teste binomial, teste t-Student e regressão logística. Resultados: Verificou-se que apresentar desvio em abertura (p < 0,02) e desvio em protrusão (p < 0,03) aumentaram as chances de os RB acordarem com a boca seca; apresentar desvio em protrusão aumentaram as chances de os RB mastigarem bem os alimentos (p < 0,05); apresentar desvio em OVERJET e idade ≥ 10 anos aumentaram as chances de os RB terem dificuldades em aprender quando comparados àqueles que não apresentaram o desvio (p = 0,07) e àqueles que estavam na faixa etária < 10 anos (p < 0,05), respectivamente. Conclusão: Os desvios em abertura, em protrusão e em OVERJET foram às adaptações da ATM que apresentaram mais chances de se associaram aos aspectos autopercebidos pelos RB em relação à alimentação, à escolaridade e ao sono.Palavras-chave: articulação temporomandibular, escolaridade, mastigação respiração bucal, sono.

Este artigo teve como objetivo apresentar por meio de uma revisão de literatura a eficácia, segurança e satisfação dos pacientes com o uso de hidroxiapatita de cálcio como preenchedor e como bioestimulador de colágeno. Trata-se de uma revisão de literatura realizada por meio de busca ativa dos artigos cientificos na base de dados: U.S. National Library of Medicine (PubMed), utilizando como termo de busca: calcium hydroxylapatite cosmetic. Foram selecionados 69 publicações, no periodo de 2016 à 2021, entretanto à partir dos critérios de inclusão e exclusão foram selecionados 20 artigos. Baseado na revisão de literatura feita neste estudo, a hidroxiapatita de cálcio mostrou-se eficaz como bioestimulador de colágeno e elastina ; como preenchedor apresentou um melhor efeito lift (exceto no caso do lift de sobrancelha) por causa do seu alto módulo de elasticidade, podendo ser usado como suporte para outros preenchedores e fios de sustentação; teve um elevado nivel de satisfação dos pacientes; é considerado um material com um bom perfil de segurança, desde que respeitada a técnica e as indicações ; e pode ser visualizado em radiografias, tomografias e ultrassonografias de alta resolução.

This study aimed to present a literature review with data obtained in vitro and in vivo on metal free partial fixed protheses (PFP) in the posterior region, considering the following variables: ceramic material to be used; prosthesis extension; survival or longevity; main failures found, and comparison with the longevity of conventional metaloceramic PFP. A bibliographical survey was carried out using the databases: United States National Library of Medicine (PubMed) and Scientific Electronic Library Online (Sciello) for articles in English and Portuguese from 1998 to 2019. Articles should meet the inclusion criteria, which were articles that contained information that enabled the calculation of PFPs survival and success, articles with a minimum observation period of 3 years, articles that identified the reason of failures, and studies reported since 1998. Sixteen studies met the inclusion criteria and were evaluated comparatively. The survival rate of the PFP’s varies depending on the ceramic material used and the prostheses extension, no significant difference was observed in the relation between the ceramic material used and the connectors size; however, the greater the extension of the prosthesis, the higher must be the connector size. It was concluded that ceramic materials based on zirconia are the ones that have the longest survival. In addition, the main reasons that lead to decreased survival of PFP’s are secondary caries and connector fracture, however, more studies are needed to determine safely which materials and the extent of PFP’s are the most indicated.