Effect of orthodontic management and orofacial muscle training protocols on the correction of myofunctional and myoskeletal problems in developing dentition. A systematic review and meta‐analysis

Abstract

The aim of this review was to evaluate available evidence on the effect of early orthodontic management and myofunctional treatment in the developing dentition children, on anterior open bite correction, as well as on normalization of patterns of mouth breathing, swallowing and tongue resting position and pressure. Electronic searches in MEDLINE, Cochrane and LILACS, without language restrictions were conducted. Additionally, unpublished literature was identified. Randomized controlled trials, or controlled clinical trials, comparing interventions applied to manage anterior open bite and other muscle functions such as breathing/swallowing pattern and tongue resting position and pressure, were considered. Quality assessment was based on the Cochrane Risk of Bias tool. Random effects meta-analyses were conducted to assess treatment effects. From the 265 initial search results, 15 articles were included in the review. Eight were randomized controlled trials (RCTs) and 7 were controlled clinical trials. Treatment outcomes comprised skeletal and dentoalveolar changes recorded cephalometrically, mouth posture and lip closure normalization, improvement of tongue resting position/pressure and modification of swallowing pattern. Quantitative synthesis was possible for only 2 of the included RCTs. There was no evidence to support bonded lingual spurs over banded fixed appliances for the correction of anterior open bite in mixed dentition children presenting nonnutritive oral habits at the onset of treatment (SMD: -0.03; 95%CI: -.81, 0.74; P = 0.94). Although early orthodontic management and myofunctional treatment in the deciduous and mixed dentition children appears to be a promising approach, the quality of the existing evidence is questionable.

Impact of Oral Myofunctional Therapy on Orofacial Myofunctional Status and Tongue Strength in Patients with Tongue Thrust

“…Several protocols of OMT for tongue thrust have been described in the literature [14,23,24]. To the best of our knowledge, no study compared the efficacy of different OMT protocols.…”

Brain Cortex Activity in Children With Anterior Open Bite: A Pilot Study

“…In this context, therapies to establish correct rest position of the tongue, such as orofacial myofunctional therapy (OMT) ( Van Dyck et al, 2016 ), could also influence the brain cortex plasticity, necessary to avoid relapse in orthodontic treatments of AOB. However, the quality of the evidence on this topic is still questionable ( Koletsi et al, 2018 ).…”

Terapia miofuncional: tratamiento alternativo para corregir mordida cruzada anterior en 15 días en un paciente de 8 años de edad. Reporte de un caso.

“…La maloclusión es definida como una condición caracterizada por relaciones anormales entre las unidades dentarias 1 representa el punto final, clínicamente observable, de numerosas influencias genéticas y ambientales 2,3 . Un ejemplo claro de dicha expresión es, sin duda, la mordida cruzada anterior, que se presenta con una prevalencia entre el 2,2 al 36% 4,5 y afecta en gran medida a pacientes pediátricos en desarrollo, sobre todo en etapa de dentición mixta 5 .…”

“…La Terapia Miofuncional Oral, introducida principalmente por Rogers a principios de la década de 1900 7 , se basa en ejercicios destinados a proporcionar un equilibro funcional a través de la reeducación del patrón neuromuscular para corregir posturas funcionales y de reposo anormales 2,3,[8][9][10] . Aunque su concepto ha sido discutido y ha generado un gran debate desde esta época, los beneficios para el tratamiento de mal oclusiones, en particular de mordida cruzada anterior, no ha sido abordada ampliamente en publicaciones científicas 2,3 .…”