Long-term evaluation of orofacial function in children with Down syndrome after treatment with a stimulating plate according to Castillo Morales

Abstract

The aim of this investigation was to evaluate the long-term orofacial development of Down children who received plate therapy according to Castillo Morales in their early childhood. The orofacial development of 27 Down children was documented before and after plate therapy and at a follow-up examination 13 years ± 6 months after initiation of therapy. The orofacial appearance significantly improved during therapy (p=0.00). During the follow-up, mouth posture remained stable (p=0.259), whereas tongue position further improved (p=0.034). A better long-term development was documented in children with initial severe orofacial dysfunctions.

Oral Health in Individuals with Down Syndrome

“…Early appliance therapy using Castillo-Morales plate had been promising in stimulating the lips and tongue and improving oromotor function (Carlstedt et al, 2003, Backmän et al, 2007. A long-term follow up study of children with DS, being treated with Castillo-Morales plate at a mean age of 13 months for 19 months, showed improved orofacial appearance and function that remain stable after 13 years (Korbmacher et al, 2006). Oromotor therapy may also be combined with functional orthodontic treatment such as palatal expansion with removable appliance, elimination of occlusal interference by grinding and use of composite overlay to free mandibular movement in older DS children (Faulks et al, 2008b).…”

Masticatory dysfunction in persons with Down’s syndrome. Part 2: management

“…The results of this type of intervention have so far been very promising (6,(12)(13)(14)(18)(19)(20)(21)(22)(23). The technique has been reported to help establish a rest position of the tongue behind the incisors, improve the position and strength of the lips, reduce tongue protrusion, encourage nasal breathing, reduce mandibular protrusion and correct the open mouth habit (8,12,37).…”

“…The technique has also been reported to be helpful in eliminating drooling and improving swallowing and mastication (6,8,9,12,13). The results are variable depending on the child's cooperation but the best results have followed very early intervention (between the age of 3 months and 4 years) (6,(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). This may be explained by the concept of a 'critical period' for the introduction of certain stimuli after which a particular pattern of behaviour becomes increasingly difficult to learn (38).…”

“…Different techniques of myofunctional stimulation and appliance therapy have been proposed, and results have generally been positive provided the treatment is commenced at a very young age and if multidisciplinary collaboration is systematic (between speech therapists, physiotherapists, ENT specialists and dentists, etc.) (6,(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). For older children, conventional orthodontic treatment may also be successful when multidisciplinary cooperation allows.…”

Outcome of orthodontic palatal plate therapy for orofacial dysfunction in children with Down syndrome: A systematic review

“…This developmental disability occurs in almost 1:700‐1000 births and poses a greater risk of medical problems for the child . Several cranial and orofacial dysmorphic features have been also described in children with DS, including small cranium, flattened face, slanted eyes, sloping under chin and low muscle tone in the orofacial region . Lip closure is mostly poor, and the mouth is often kept open with a protruded tongue resting inactively between the lips .…”