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Impacto do uso prolongado de chuchas ortodônticas versus não ortodônticas : qual é a melhor opção?
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O presente estudo analisa o impacto do uso da chucha no desenvolvimento orofacial, oclusal e funcional do lactente e da criança pequena, integrando aspetos ergonómicos, anatómicos, materiais e clínicos. O uso prolongado da chucha é reconhecido como um hábito de sucção não nutritiva, potencialmente responsável por alterações estruturais do palato, modificações no posicionamento da língua e distúrbios oclusais em idades precoces.
A presente revisão da literatura inclui trabalhos recentes sobre mecânica da sucção, design e geometria das chuchas e biomecânica orofacial, com base em estudos laboratoriais, ensaios clínicos e análises por elementos finitos. Foram descritos os principais componentes da chucha — tetina, escudo, anel, pino e botão — e analisados os materiais predominantes, silicone e látex, quanto às suas propriedades de higiene, resistência, flexibilidade e segurança química.
Os resultados indicam que as chuchas ortodônticas, com tetina achatada e zona do pescoço estreita, tendem a exercer menores pressões laterais e anteroposteriores sobre o palato quando comparadas com os modelos convencionais de formato “cereja”. No entanto, a evidência científica permanece inconclusiva quanto à sua eficácia preventiva de maloclusões, sendo o tempo de uso, a frequência e a intensidade da sucção os fatores mais determinantes no desenvolvimento oclusal do que o tipo de chucha isoladamente.
No que respeita aos materiais, o silicone apresenta melhor desempenho higiénico e resistência térmica, mas é mais rígido e suscetível à rutura por mordedura. O látex, mais flexível e confortável, degrada-se mais facilmente e pode desencadear reações alérgicas devido à presença de proteínas naturais e resíduos químicos. A norma EN 1400-1:2018 estabelece os critérios de segurança e ergonomia que devem orientar a conceção e fabrico destes dispositivos.
Assim, a escolha da chucha deve equilibrar conforto, segurança e impacto funcional, considerando a idade da criança e o padrão de sucção. Recomenda-se aos cuidadores a adoção de boas práticas de higiene, a utilização racional e o desmame gradual até aos dois anos de idade, prevenindo assim alterações orofaciais e miofuncionais permanentes.
The present study examines the impact of pacifier use on the orofacial, occlusal, and functional development of infants and young children, integrating ergonomic, anatomical, material, and clinical aspects. Prolonged pacifier use is recognized as a non-nutritive sucking habit that may contribute to structural alterations of the palate, changes in tongue positioning, and occlusal disturbances at early ages. The literature review includes recent studies on sucking mechanics, pacifier design and geometry, and orofacial biomechanics, based on laboratory experiments, clinical trials, and finite element analyses. The main components of the pacifier — nipple, shield, ring, stem, and button — are described, and the predominant materials, silicone and latex, are analyzed in terms of their hygienic properties, resistance, flexibility, and chemical safety. The findings indicate that orthodontic pacifiers, characterized by a flattened nipple and a narrow neck zone, tend to exert lower lateral and anteroposterior pressures on the palate compared with conventional “cherry-shaped” models. However, scientific evidence remains inconclusive regarding their preventive efficacy against malocclusions. The duration, frequency, and intensity of sucking appear to be more decisive factors in occlusal development than the type of pacifier alone. Regarding materials, silicone offers superior hygienic performance and thermal resistance but is more rigid and susceptible to tearing from biting. Latex, being softer and more flexible, provides greater comfort but degrades more easily and may trigger allergic reactions due to natural proteins and chemical residues. The EN 1400-1:2018 standard defines the safety and ergonomic requirements that should guide the design and manufacture of these devices. In conclusion, the choice of pacifier should balance comfort, safety, and functional impact, taking into account the child’s age and sucking pattern. Caregivers are advised to adopt good hygiene practices, ensure rational use, and promote gradual weaning by the age of two, thereby preventing permanent orofacial and myofunctional alterations.
The present study examines the impact of pacifier use on the orofacial, occlusal, and functional development of infants and young children, integrating ergonomic, anatomical, material, and clinical aspects. Prolonged pacifier use is recognized as a non-nutritive sucking habit that may contribute to structural alterations of the palate, changes in tongue positioning, and occlusal disturbances at early ages. The literature review includes recent studies on sucking mechanics, pacifier design and geometry, and orofacial biomechanics, based on laboratory experiments, clinical trials, and finite element analyses. The main components of the pacifier — nipple, shield, ring, stem, and button — are described, and the predominant materials, silicone and latex, are analyzed in terms of their hygienic properties, resistance, flexibility, and chemical safety. The findings indicate that orthodontic pacifiers, characterized by a flattened nipple and a narrow neck zone, tend to exert lower lateral and anteroposterior pressures on the palate compared with conventional “cherry-shaped” models. However, scientific evidence remains inconclusive regarding their preventive efficacy against malocclusions. The duration, frequency, and intensity of sucking appear to be more decisive factors in occlusal development than the type of pacifier alone. Regarding materials, silicone offers superior hygienic performance and thermal resistance but is more rigid and susceptible to tearing from biting. Latex, being softer and more flexible, provides greater comfort but degrades more easily and may trigger allergic reactions due to natural proteins and chemical residues. The EN 1400-1:2018 standard defines the safety and ergonomic requirements that should guide the design and manufacture of these devices. In conclusion, the choice of pacifier should balance comfort, safety, and functional impact, taking into account the child’s age and sucking pattern. Caregivers are advised to adopt good hygiene practices, ensure rational use, and promote gradual weaning by the age of two, thereby preventing permanent orofacial and myofunctional alterations.
Descrição
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Palavras-chave
Chucha Ortodôntica Convencional Sucção não-nutritiva