Artículos de Investigadores

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A Novel Three-Dimensional Analysis of Tongue Movement During Water and Saliva Deglutition: A Preliminary Study on Swallowing Patterns
(2018)
Giannina Álvarez
;
Fernando José Dias
;
María Florencia Lezcano
;
Alain Arias-betancur
;
Ramón Fuentes
Deglutition is a complex oral function, and the study of the whole process requires a precise analysis of the elements involved, especially of the tongue biomechanics. We described a three-dimensional analysis of tongue movements during both saliva and water deglutition in participants with normal occlusion. Fourteen participants (25.36 ± 4.85 years) were evaluated, and the movements of anterior, middle, and posterior portions of the tongue were recorded using AG501 3Delectromagnetic articulograph. An average volume (AVS) for water deglutition was determined for each participant. Saliva deglutition was classified according to Bourdiol et al. 35.71% was type I, 14.29% type II, and 50% type III. The greatest displacement on the inferior–superior axis was in the posterior portion, followed by the middle and anterior portions. In the posterior–anterior axis, smallest movement was in the anterior portion. During water deglutition, on the inferior–superior axis, there were statistical differences for 1-AVS between the anterior/middle and anterior/posterior portions of the tongue. There were statistical differences for both -AVS and -AVS between the anterior/posterior portions of the tongue. On the posterior–anterior axis, there were no statistical differences among any volume–portion relations. On the medial–lateral axis, there was statistical difference for the -AVS between middle and posterior portions. The movement of the tongue portions was influenced by the volume and the element to be swallowed. The amplitude of the movement was directly proportional to the volume of water swallowed.
Analysis of mandibular movements and chewing cycles in patients with Skeletal Class III: a preliminary study using 3D electromagnetic articulography
(2018)
Ramón Fuentes
;
Diana Constanza Farfán Melo
;
Fernando J. Dias
;
Alain Arias-betancur
;
María Florencia Lezcano
Background. Study of mandibular movements (MM) was introduced into oral physiology to increase knowledge of the stomatognathic system and achieve better results in treatments. Electromagnetic Articulography (EMA), specifically the most recent equipment, AG501, plays an important role in these objectives, since it permits description of movements in 3 dimensions by recording the position of body parts at a high sampling frequency. Aim. The aim of the present study was to report an exploratory analysis of the geometrical characteristics (area, trajectory, ranges) and the velocity of border and functional MM in patients with Skeletal Class III by the use of EMA AG501. Material and methods. Two individuals with skeletal class III, patients at the Dental Teaching Clinic of the Dental Faculty of Universidad de La Frontera, Chile, were assessed and the results were processed with computer scripts developed specifically for this study. Results. The result produced from border MM was Posselt's envelope in the frontal and sagittal planes, allowing analysis of the morphology and area. The result obtained from the mastication movements was an assessment of the area of each chewing cycle, which was compared with the area of the envelopes in the various planes. We also analysed the number, frequency and velocity of cycles, comparing them with available data.
Application of 3D electromagnetic articulography in dentistry: Mastication and deglutition analysis. Protocol report
(2018)
Ramón Fuentes
;
Fernando Jose Dias
;
Giannina Álvarez
;
Lezcano, María Florencia
;
Diana Constanza Farfán Melo
;
Nicolás Astete Sepúlveda
;
Alain Arias-betancur
The Stomatognathic System (SS) is an integrated and coordinated morphofunctional unit, consisting of skeletal, muscular, angiological, nervous, glandular and dental structures that work in harmony to perform different functions such as chewing, swallowing, speaking, breathing, tasting and esthetics. The study of SS physiology is crucial to achieving a correct maintenance of its normal function or restoration. Thus, we developed a protocol to record mandibular movement, chewing and swallowing (saliva and water) by using the 3D-electromagnetic articulograph AG501 at the Oral Physiology Laboratory of the Research Centre for Dental Sciences (CICO). This tool has been used for decades in speech and phonetic research and it is able to record, present and evaluate articulated structure movement data in real time. The articulograph provides an ordered data matrix (values for the x, y, z axes, among others) for the recorded movement, which is stored in binary files that can be processed by different software. One of these is MATLAB¨, allowing us to perform a quick, clear and understandable analysis. The existence of a standardized methodology for recording allows an accurate description of the stages to perform different types of measurements according to the researcherÕs objective. This has opened the way for a new type of oral physiology analysis based on study reproducibility, which is considered one of the bases of scientific methodology.
Bilateral bifid mandibular canal: a case report using cone beam computed tomography
(2018)
Ramón Fuentes
;
Constanza Farfán
;
Nicolás Astete
;
Ivonne Garay
;
Fernando Dias
;
Alain Arias-betancur
The mandibular canal (MC) originates in the mandibular foramen and runs bilaterally through the mandibular ramus and body, ending in the mental foramen. One of the most common anatomical variations is bifid MC, the configurations of which have been classified into four categories and sub-categories. The prevalence of these variations depends on the imaging method used. Studies carried out in panoramic X-rays and cone beam computed tomography (CBCT) show prevalences varying between 1% and 20%. In this case report we present the finding of a bilateral bifid MC by CBCT examination; we describe its location and morphological characteristics. The variation found was a type 1 bilateral bifid MC, which consists in an accessory canal originating from a single mandibular foramen and extending to the third molar or its immediate surroundings. In this report we discuss the importance of detecting these anatomical variations, as well as their implications in clinical practice. (Folia Morphol 2018; 77, 4: 780–784)
Delayed Diagnosis of a Supernumerary Tooth in an Adult Patient: Treatment Considerations As Regards One Case
(2018)
Ramón Fuentes
;
Diana Constanza Farfán Melo
;
Nicolás Astete Sepúlveda
;
Nallely Ivonne Garay Arce
;
Fernando Jose Dias
;
Alain Arias-betancur
(Background) Hyperdontia is an excess in the total number of teeth and if their morphology resembles a normal tooth, they are called supplementary teeth. Its etiology is not yet understood in its entirety but there are several hypotheses on the matter. (Aim) In this case report, we present the accidental finding of a supernumerary tooth in a 57-year-old woman through a digital panoramic x-ray and we discuss its approach. (Material and Methods) When the computed cone beam tomography was requested, the tooth was characterized with morphometric measurements. (Results) The mesiodens, small, with a conical crown and curved root, was observed in a palatal position relative to teeth 1 1 and 1 2, in distoversión (its crown was in contact with the root of tooth 1 2). It is noted slight root resorption and discontinuity of the palatal alveolar cortex. The cortex of the nasal cavity and the alveolar vestibular cortex were preserved. In this context, it was decided to maintain the supernumerary tooth and observe its evolution every 3 years. This approach was based on the fact that throughout the intraosseous progression of the tooth, it has never caused symptoms or complications for the patient. In addition, the benefits of extraction are not so clear. (Conclusion) As a rule, supernumerary teeth are extracted early to avoid possible complications; however, in cases like this, the treatment decision must be based on adequate clinical and imaging examinations, complemented by a risk-benefit analysis of the treatment, and considering the patient’s desires.
Dientes Supernumerarios Suplementarios en un Paciente Adulto Parcialmente Dentado: Reporte de Caso
(2018)
Ramón Fuentes
;
Giannina Álvarez
;
Ivonne Garay
;
Alain Arias-betancur
;
Fernando José Dias
Aquellos casos en que se excede la cantidad normal de dientes para la fórmula primaria o definitiva se conocen como dientes supernumerarios o hiperodoncia. Esta puede presentarse de manera aislada o múltiple, unilateral o bilateral y afectar tanto a la maxila como a la mandíbula. Es más prevalente en hombres, en dentición permanente y en el maxilar, siendo el mesiodens el supernumerario encontrado con mayor frecuencia. Su etiología aún no está del todo clara, sin embargo, una hiperactividad de la lámina dental junto a una asociación de factores genéticos y ambientales sería la teoría más aceptada. Pueden ser asintomáticos y detectados solo en radiografías o pueden presentar manifestaciones clínicas como apiñamiento, retardo en la erupción, reabsorción radicular, diastemas entre otros. El tratamiento depende del tipo de diente y de su relación con las estructuras adyacentes. En el siguiente reporte presentamos el caso de un paciente de sexo masculino, de 54 años de edad, no sindrómico, desdentado parcial superior e inferior que acude a una consulta dental privada (Temuco) para solicitar tratamiento rehabilitador. En la radiografía panorámica de rutina se observan dos dientes supernumerarios, uno a cada lado de la mandíbula y en la región premolar. Al examinar este hallazgo con tomografía computarizada cone beam se determina que el supernumerario del lado derecho corresponde a un premolar suplementario y el de la izquierda a un supernumerario de morfología molariforme. En este caso se decide extraer los dientes debido a la localización de estos y a las implicancias con el tratamiento rehabilitador posterior.
Morphological variations of the mandibular canal in digital panoramic radiographs: a retrospective study in a Chilean population
(2018)
Ramón Fuentes
;
Alain Arias-betancur
;
Constanza Farfán
;
Nicolás Astete
;
Ivonne Garay
;
Pablo Navarro
;
Fernando J. Dias
Background: Morphological variations of the mandibular canal (MC) have been described in literature, so the clinician must be able to recognise them and adapt their treatment accordingly. The aim of this study was to determine the prevalence of morphological variations of the MC using digital panoramic radiographs (DPR) of Chilean patients. Materials and methods: A retrospective study in which 1400 DPR were analysed to identify cases of bifid, trifid and retromolar MC. The radiographs were analysed independently by two examiners who had previously been trained by a specialist in oral and maxillofacial radiology. Inclusion and exclusion criteria were applied to reach a final sample. Results: Nine hundred and twenty-five radiographs were included (599 female, 326 male; mean age 36.1 ± 15.54 years). The prevalence of bifid MC was 11% (n = 102), with no significant differences by sex (p = 0.069). Proportion of bifid MC was higher among younger patients (p = 0.038). Prevalence of morphological variations of type 1 bifid MC was 7.4% (n = 69), type 2 was 2.3% (n = 23), type 3 was 0% (n = 0) and type 4 was 1.1% (n = 10). Prevalence of retromolar canal was 0.9% (n = 8), with no significant differences by sex (p = 0.893) or age (p = 0.371); of these, 2 (0.2%) cases were forward type and 6 (0.6%) cases were retromolar type. No cases of trifid MC were found. Conclusions: Digital panoramic radiographs are useful for detecting morphological variations of the MC; we were able to identify three types of bifid MC as well as retromolar canals. Proper identification of these variations by an easily accessible examination is important for avoiding possible complications in clinical-surgical practice. (Folia Morphol 2019; 78, 1: 163–170)
Patrones de Deglución y Metodología de Evaluación. Una Revisión de la Literatura
(2019)
Priscila Chuhuaicura
;
Giannina Álvarez
;
Lezcano, María Florencia
;
Alain Arias-betancur
;
Fernando Jose Dias
;
Ramón Fuentes
La deglución es una función indispensable para el ser humano, es una actividad compleja que necesita de la participación y coordinación de múltiples estructuras. Actualmente existen diferentes métodos para evaluar este proceso, sin embargo, la capacidad de describir el comportamiento de las estructuras en sus tres dimensiones es limitada. Se ha demostrado que el movimien to lingual, es clave para la formación del bolo alimenticio y la propulsión de este a la orofaringe. Es así como se han identificado patrones de movimiento lingual a través de diferentes técnicas. El objetivo de esta revisión es reportar las diferentes técnicas de evaluación de la deglución e identificar los patrones que establece cada una de ellas. Se realizó una revisión de la literatura en distintas bases de datos, a través de una estrategia de búsqueda sistematizada. Se utilizaron las palabras clave “Deglutition” “Swallowing” “Movement Tracking” “evaluation” y “patterns” en inglés y español. Se incluyeron estudios sin límite en la fecha de publicación, realizados en humanos, en idioma inglés, español y portugués. Se encontraron diferentes técnicas para evaluar la deglución, videofluoroscopía, endoscopía, articulografía electromagnética, electromiografía, tomografía computarizada, manometría, electropalatografía y ultrasonido. Entre las cuales la videofluoroscopía es una de las más utilizadas, con esta técnica se ha intentado describir patrones del movimiento durante la deglución, al igual que la articulografía electromagnética. Por otro lado, la electromiografía ha descrito patrones de deglución, pero en relación a la contracción y relajación de ciertos grupos musculares. Existen diferentes métodos para evaluar la deglución, cada una de estas técnicas ha permitido dilucidar de mejor forma este proceso, no obstante, es necesario una mayor cantidad de estudios comparativos que permitan resolver las dudas sobre la validez y la eficacia de las técnicas descrit

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