Study of a New Technique to Improve the Symptoms of Orofacial Discomfort in Patients With Peripheral Facial Paralysis
Condition: Peripheral Nerve Facial Nerve Paralysis; Facial Nerve Diseases; Orofacial Pain
MeSH terms: Bell Palsy; Facial Paralysis; Facial Nerve Diseases; Paralysis; Nervous System Diseases; Facies; Facial Pain
Study type: Interventional

Summary: 
      -  The purpose of this study was to evaluate the effects of Neuro Occlusal Rehabilitation
           (RNO) in patients with peripheral facial palsy (PFP) disease, noting the decrease in
           symptoms of masticatory dysfunction.

        -  According to Carvalho (2009) patients with PFP have chronic unilateral masticatory
           preference. Santos et al. (2009) in the same year noted that these conditions can lead
           to problems with temporomandibular disorder.

        -  Hypothesis- known that performing occlusal adjustment in these patients with chronic
           PFP, ensuring a maximum of dental contacts and a final stop of the masticatory cycle
           stable, providing a balanced occlusion.

        -  dental cleaning was performed in two groups for the blind study

        -  visual analog scale -To assess the quality of the oral functions of these patients, the
           investigators applied the visual analog scale(VAS) and statistically evaluated the
           degree of satisfaction regarding the functions of oro facial in relation to mastication
           and temporomandibular dysfunction.

        -  gnathostatic models were made in the treatment group in the first and last query.

        -  occlusal adjustment in treatment group.In the group treated occlusal adjustment was made
           in the teeth and applied a new (VAS) before and after treatment.

      The RNO, is defined as a part of medicine that operates in stomatology occlusal plane as a
      guide to a harmonious development of the face, chewing facilitating bilateral and
      alternating. (Planas, 1997). It works through selective grinding on the occlusal platform,
      providing an increased number of dental contacts.
    

Detailed description: 
      Purpose: To evaluate the effects of the Neuro-Rehabilitation occlusion in patients with
      chronic facial palsy by observing the decrease of the symptoms of masticatory dysfunction.

      Methods: a selection of sixty-five patients with facial palsy (PFP 65) and idiopathic chronic
      trauma of the Otorhinolaryngology sector facial nerve disorders at UNIFESP.

      Patients were of both genders, aged between 18 and 60. They were analyzed according to the
      criteria of inclusion and exclusion, resulting in forty-three patients.

      However, due to problems inherent in research, a group of fourteen patients were randomized
      (sub-divided) into two groups: control and treatment.

      The visual analog scale was used at the first consultation to patients in the control and
      treatment group.

      All patients underwent a dental cleaning in order to blind the study. Seven patients belonged
      to the control group for three months per sequence, the VAS was performed in both groups. The
      control group was later reunited with the treatment group after three months of control
      period, increasing the number of patients who were examined in extracts, with similar
      features in a prognostic factor.

        -  Control group

        -  First visit- visual analogue scale and dental cleaning - Day 1

        -  Second visit, after a month, a new visual analog scale. Day-30

        -  Third-visit -one months after a new visual analogue scale Day 60 patient was a three
           visits with an interval of one month, performing a repeat procedure.

             -  Last visit - Day 90 visual analogue scale

        -  Treatment group The researchers applied the technique of Rehabilitation and Neuro
           Occlusal gnathostatic models that were made before and after treatment to count the
           dental contacts.

        -  First query - visual analogue scale and dental cleaning, preparation of initial models
           gnatostaticos and intervention- Day 1

        -  Second-query-after a month, a new visual analogue and intervention. Day 30

        -  Third query- -after a month, a new visual analogue and intervention Day 60

        -  Last query -after a month a new visual analogue scale and making models gnathostatic
           finals. Day 90 The treatment group had one month to see changes in oral functions, but
           for estatistic effects was computed only de first andy the last visit the number of the
           dental contact and the VAS. Day 90 Upon completion of the study patients continued to
           receive care in the ambulatory clinic of the university, but the attendance for this
           research was terminated.
    

Intervention name(s): occlusal adjustment.; Visual analog scale.
Intervention type(s): Procedure; Behavioral
Intervention description(s): It prompted the patient to perform the act of swallowing for 3 times to reach a terminal axis of rotation of the jaw and from this to start. Will be held palpation of the muscles, masseter and temporal on both sides and compared with the marks of carbon found in the teeth. After starts the adjustment following the rules of Guichet with a cylindrical drill with a thin cut . basic principles 1 Occlusive stress maximum distribution in centric relation 2 The occlusive strengths should by the teeth's major axis.3 When the contact is surface to surface, it must be exchanged to another surface point. 4 Once the stability to the centric relation is achieved, it should be kept. The rules to guide the occlusal adjustment selective grinding .; Visual analog scale-Graduation was held on the visual analogue scale in the first and last query to measure discomfort chewing.Graduation was held on the visual analogue scale .in the first and last query to measure discomfort chewing. After graduating dental cleaning was performed, with the purpose of blinding the study, Dental Cleaning.With engine using low speed, brushes, and prophylactic paste is carried out dental cleaning in the teeth of all patient.
Dental Cleaning.With engine using low speed, brushes, and prophylactic paste is carried out dental cleaning in the teeth of all patient.
Intervention MeSH terms: Salicylic Acid
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Facial Paralysis / rehabilitation.; Dental Occlusion.; Occlusal Adjustment.; Malocclusion / therapy.