Abstract
ObjectiveTo investigate the effects of dental/skeletal malocclusion and orthodontic treatment on four main objective parameters of chewing and jaw function (maximum occlusal bite force [MOBF], masticatory muscle electromyography [EMG], jaw kinematics, and chewing efficiency/performance) in healthy children.Materials and methodsSystematic searches were conducted in MEDLINE (OVID), Embase, and the Web of Science Core Collection. Studies that examined the four parameters in healthy children with malocclusions were included. The quality of studies and overall evidence were assessed using the Joanna Briggs Institute and GRADE tools, respectively.ResultsThe searches identified 8192 studies; 57 were finally included. The quality of included studies was high in nine studies, moderate in twenty-three studies, and low in twenty-five studies. During the primary dentition, children with malocclusions showed similar MOBF and lower chewing efficiency compared to control subjects. During mixed/permanent dentition, children with malocclusion showed lower MOBF and EMG activity and chewing efficiency compared to control subjects. The jaw kinematics of children with unilateral posterior crossbite showed a larger jaw opening angle and a higher frequency of reverse chewing cycles compared to crossbite-free children. There was a low to moderate level of evidence on the effects of orthodontic treatment in restoring normal jaw function.ConclusionsBased on the limitations of the studies included, it is not entirely possible to either support or deny the influence of dental/skeletal malocclusion traits on MOBF, EMG, jaw kinematics, and masticatory performance in healthy children. Furthermore, well-designed longitudinal studies may be needed to determine whether orthodontic treatments can improve chewing function in general.Clinical relevanceComprehensive orthodontic treatment, which includes evaluation and restoration of function, may or may not mitigate the effects of malocclusion and restore normal chewing function.
Highlights
Mastication is a complex sensory-motor interaction between the central nervous system and the peripheral masticatory apparatus
The semi-automatic, rhythmic act of mastication is initiated by the central nervous system and fine-tuned by inputs from receptors embedded in the orofacial area [1]
In a previous systematic review, we examined the development of common objective indicators of chewing and jaw function in healthy children without malocclusion [23]
Summary
Mastication is a complex sensory-motor interaction between the central nervous system and the peripheral masticatory apparatus. The semi-automatic, rhythmic act of mastication is initiated by the central nervous system and fine-tuned by inputs from receptors embedded in the orofacial area [1]. The process of mastication and the coordination of masticatory movements depend largely on the harmonious interaction between the peripheral inputs and the higher centers of the brain [2–5]. The process of mastication involves the proper placement of food morsels in between the teeth, crushing (the food) into smaller pieces, and mixing them with saliva to form a coherent and swallowable bolus. In addition to the physical comminution of food, mastication plays an integral role in the process of swallowing, salivary secretion [8], taste and flavor perception, digestion, and nutrition [6, 7] in humans. It is believed that impaired chewing function can have a cascading effect on overall health and quality of life [9–12]
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