AVALIAÇÃO DA MASTIGAÇÃO: COMPARAÇÃO

AVALIAÇÃO DA MASTIGAÇÃO:
COMPARAÇÃO DE TRÊS MÉTODOS DE ANÁLISES
EM ADOLESCENTES E CRIANÇAS RESPIRADORAS ORAIS
Mastication diagnosis: comparison of three methods
of analyses in oral breathing children and adolescents
Silvia Fernandes Hitos, Dirceu Solé,, Maria Cecília Periotto,
Lúcia T N Fernandes, Luc L M Weckx, Zelita C F Guedes
UNIFESP/EPM
São Paulo, SP, Brasil
Introdução: comparação de três métodos de análise do lado mastigatório em indivíduos respiradores
orais. Método: 34 respiradores orais (7 a 14 anos) com maloclusão foram filmados com etiqueta sobre o
queixo e 20 deles sem a mesma. Os 54 vídeos foram randomizados e analisados por duas fonoaudiólogas
independentes, em velocidade normal. A pesquisadora analisou os mesmos vídeos em veocidade reduzida. Em outro momento, com o auxílio da computação gráfica, analisou os vídeos quadro-a-quadro, com
o registro do movimento mandibular nos ciclos mastigatórios. Os achados dos três tipos de análise foram
comparados entre si. Resultado: houve 79,8% de concordância entre os achados quando comparadas as
análises das duas fonoaudiólogas em velocidade normal. 70% de concordância quando comparados os
achados nas análises feitas em velocidade normal e no quadro-a-quadro. Comparados os achados obtidos
na anállise em velocidade normal e quadro-a-quadro aos obtidos com o auxílio da computação gráfica, o
nível de concordância foi maior quando a análise foi realizada em velocidade reduzida e com a etiqueta
sobre o queixo. A mastigação bilateral alternada foi a mais prevalente (64,7%) nos pacientes observados.
Conclusão: a análise dos vídeos em velocidade reduzida com o uso da etiqueta foi tão eficiente quanto a
análise em velocidade reduzida com o registro dos ciclos mastigatórios por computação gráfica.
Descritores: mastigação; respiração bucal/classificação; gravação/vídeo; computação gráfica
MASTICATION DIAGNOSIS: COMPARISON OF THREE METHODS OF
ANALYSES IN ORAL BREATHING CHILDREN AND ADOLESCENTS
Avaliação da mastigação: comparação de três métodos
de análises em adolescentes e crianças respiradoras orais
Silvia Fernandes Hitos1, Dirceu Solé2, Maria Cecília Periotto3,
Lúcia T N Fernandes4, Luc L M Weckx5, Zelita C F Guedes6
1. Master of Science, Speech Pathologist specialist, Supervisor of Centre of Oral Breather –
Federal University of São Paulo (UNIFESP-EPM)
2. Full Professor Division of Allergy, Clinical Immunology and Rheumatology, Dept of Pediatrics – UNIFESP-EPM
3. Speech Pathologist, Postgraduate student at the Department of Neurology at University of São Paulo(USP)
4. Speech Pathologist, volunteer worker at the Centre of Oral Breather at UNIFESP-EPM
5. Full Professor, Dept Otorrinolaringology, Head and Neck Surgery, UNIFESP-EPM
6. Associated Professor, Dept of Speech, language and audiology, UNIFESP-EPM
São Paulo – São Paulo- Brasil
Original Article
Introdution: in the speech pathology area, studies have revealed an important technological delay and the
lack of patterns at the assessment of mastication.The paucity of studies on the efficiency of the resources
to mastication diagnosis has motivated this study in children and adolescents mouth breathers. Objective:
to compare three methods applied to analyze the side of mastication in oral breathing subjects. Method: 34
oral breathers (7 to 14 years old) with malocclusion were taped during assessment with a tag on their chin.
20 of them were also taped without it. These 54 videos obtained were analyzed by different speech therapists
in a random and independent manner. Firstly, videos were analyzed by one of the researchers and watched
in a frame by frame model. Two independent speech therapists also analyzed the videos watching them in
normal speed. The videos were then analyzed in slow motion and linked to the registration of the chewing
cycles, in front plane, through graphical computing techniques. The three analyses of chewing side were
compared to each other. Results: there was a minimal 79.8% agreement rate between the analyses done
by the two speech therapists watching the video in regular speed. The minimal agreement rate obtained
when the frame to frame analysis was compared to the regular speed analysis was 70.0%. The agreement
level was higher when the comparison was made between the data obtained from the three evaluators to
that from the analysis in reduced speed linked to graphical computing techniques. Alternated and bilateral
mastication was the most prevalent (64.7%) in the observed patients. 64% (22) of the subjects revealed a
frequency of 60 to 80% of rotatory mandibular movements for 50 seconds and a mastication cycle while
eating a French bread that varied from 0.9 to 1.3 seconds for 75% of the subjects. Conclusion: the analyses
of the videos in reduced speed with the tag were as efficient as the analysis with reduced speed linked to
the register of the cycles through graphical computing techniques.
Keywords: mastication; mouth breathing/classification; video recording; image processing, computer-assisted