Myofunctional Disorders Research Articles

Tongue and Lip Strength and Endurance in Healthy Young Adults With and Without Orofacial MyofunctionalDisorders.

Based on the premise that tongue and lip force is affected in individuals with orofacial myofunctional disorders (OMDs), orofacial myofunctional therapy (OMT) programs typically include the strengthening of orofacial muscles through isometric and isotonic exercises. The purpose of this study is to examine whether there is indeed a measurable difference in maximum tongue and lip strength and endurance between subjects with and without OMDs, as well as to explore Oral Health-Related Quality of Life (OHRQoL) in this population. Sixty healthy young adults (mean age 18.9 years, SD 0.69 years, range 18.0-21.4 years) participated in this study. Perceptual evaluation of orofacial functions was conducted using the Orofacial Myofunctional Evaluation with Scores (OMES) protocol. Participants were divided into three groups, namely those with physiological orofacial functions (POF; n = 20), those with inconsistent orofacial functions (IOF; n = 11), and those with consistent OMDs (OMD; n = 29). Maximum isometric pressure and endurance of tongue and lips were measured using the Iowa Oral Performance Instrument (IOPI). OHRQoL was assessed using the Oral Health Impact Profile (OHIP-14). The OMES total scores did not differ significantly between the three groups, though the subscale 'function' showed significant differences (13.637; p = 0.001). No statistically significant differences in maximum isometric pressure or endurance for tongue and lips, nor for OHIP scores, were measured between the three groups. Although orofacial muscle strengthening is commonly part of OMT, current findings suggest the superfluity of these types of exercises in the treatment of OMDs in healthy young adults and may indicate the need to focus on awareness and rehabilitation of pathological functions in these individuals. Re-evaluation of the efficacy of OMT programs in different populations may be an important strategy going forward.

The test of masticating and swallowing solids (ToMaSS): An investigation of applicability and clinical utility in children with orofacial myofunctional disorders.

Orofacial myofunctional disorders (OMD) are often associated with limitations of oral ingestion of solid food. The Test of Masticating and Swallowing Solids (ToMaSS) is a simple diagnostic tool to assess and quantify oropharyngeal efficiency while eating a standardised cracker. The objective of this study was to investigate the applicability and clinical utility of the ToMaSS in children with OMD. In this case-control study, data were collected from 18 children between 4 and 11 years with confirmed OMD. Inter-rater reliability and age effects on the ToMaSS parameters were investigated and the specific performance profile of the OMD children was identified. Inter-rater reliability was excellent for the ToMaSS parameters 'bites' (ICC = .999), 'masticatory cycles' (ICC = .961), 'time'(ICC≧ .999) and good for 'number of swallows' (ICC = .810). 'Masticatory cycles' and 'time' decreased as a function of age with a significant difference in the 'number of masticatory cycles' between the youngest (4-6 years) and oldest (10-14 years) participants (p = .006, Z = -2.739). Deviations from normative data in at least one of the four ToMaSS parameters were found in 90% of the OMD children with 'bites', and 'masticatory cycles' predominantly corresponding to the performances expected in typically-developing children in younger age groups. The ToMaSS is a reliable diagnostic instrument and clinically useful to detect limited efficiency of oral solid bolus intake and specific impairments in chewing function and duration of food intake in children with OMD. Our data suggest that OMD is associated with delayed development of efficient solid bolus preparation.

Use of hyperboloid as an adjunct in functional jaw orthopedics – case report

Anterior open bite can be defined as a malocclusion with a negative vertical discrepancy between the incisal edges of the upper and lower anterior teeth, which do not have occlusal contacts with the antagonists and sometimes extends to the canines and, less frequently, to the premolars is one of the malocclusions with the greatest aesthetic and/or functional impairment. Anterior open bite can have several etiologies: finger sucking and/or pacifier, oral breathing, onychophagia, lip interposition, atypical swallowing, tongue interposition when uttering phonemes and anterior posture of the tongue at rest. Orofacial myofunctional disorders are present in cases of anterior open bite, generally associated with etiologies and adapt to this altered morphological condition. Regarding the anterior opening amplitude, the anterior open bite is classified as: minimum up to 1 mm, moderate between 1 and 5 mm and severe +5 mm [1]. Open bite can be classified into: maxillary, mandibular and hybrid open bite [2]. Myofunctional therapy is considered a treatment method that can increase muscle strength, cause changes in functional patterns and thus prevent deviations in craniofacial development, as it promotes new posture of structures at rest and during the performance of the functions of the stomatognathic system [3]. The hyperboloid is an instrument for increasing muscle tone and when used in chewing, it is efficient in inducing growth and remodeling. The hyperboloid fills a gap in the modern diet, with the consistency of hard, raw and dry foods [4]. Exercises with a size M hyperboloid with wire were prescribed as an initial approach. After 2 months of treatment, there was an improvement in the interincisor distance. The exercise was maintained for another 5 months. He stopped attending appointments for 2 years and 2 months. Upon his return, the results of the functional examination of swallowing, chewing, protrusion and laterality were observed, and we opted for the installation of the SN3. the hyperboloid, in this case, showed its efficiency in balancing the stomatognathic system.

Tongue strength and swallowing-related masseter activity and oropharyngeal timing across the lifespan

Purpose: This study examined lifespan changes in maximum tongue strength, swallowing time, and masseter activity during swallowing. It provides normative data with which to compare clinical assessments of orofacial myofunctional disorders (OMD) and oropharyngeal dysphagia (OPD). Method: 409 healthy participants without identified OMD or OPD (ages 5 – 79 years) provided instrumental measures of tongue strength and electromyographic measurements for oropharyngeal transit time and masseter activity during swallows of four boluses. Participants were placed in three broad age groups (5 – 15, 16 – 59, 60 – 79) for crosssectional analysis. Results: Differences were found between age groups for tongue strength, such that the youngest group had significantly lower anterior tongue strength than the other groups, and lower posterior tongue strength than the 16 – 59 age group. Anterior tongue strength was significantly greater for males than females; posterior tongue strength did not differ significantly between the sexes. The youngest group had longer oropharyngeal transit times than either of the two older groups for most boluses. Swallowing transit time decreased in duration across the age groups, from youngest to oldest, for the 2.5 cc pudding bolus. Both right and left masseters differed in activation among tasks and age groups. The oldest age group had consistently greater levels of activation of the right masseter, and all groups had greater activation for the cracker bolus. Spearman rank-order correlations largely confirmed the inferential statistics and provided evidence of a relationship between tongue weakness and increased oropharyngeal transit time. Conclusion: Maximum tongue pressure generation and oropharyngeal timing measures support a developmental hypothesis, with lower tongue strength and longer swallowing transit times for children ages 5 through 15. The smaller pudding bolus provided the greatest differentiation among the age groups, which may prove to be a functional indicator for clinical evaluation. These results are largely consistent with existing data for tongue strength and oropharyngeal swallowing transit times.

Serious Games in Orofacial Myofunctional Disorder Therapy for Children: An Expert Survey.

Orofacial Myofunctional Disorder (OMD) is believed to affect approximately 30-50% of all children. The various causes of OMD often revolve around an incorrect resting position of the tongue and cause symptoms such as difficulty in speech and swallowing. While these symptoms can persist and lead to jaw deformities, such as overjet and open bite, manual therapy has been shown to be effective, especially in children. However, much of the therapy must be done as home exercises by children without the supervision of a therapist. Since these exercises are often not perceived as exciting by the children, half-hearted performance or complete omission of the exercises is common, rendering the therapy less effective or completely useless. To overcome this limitation, we implemented the LudusMyo platform, a serious game platform for OMD therapy. While children are the main target group, the acceptance (and usability) assessment by experts is the first milestone for the successful implementation of an mHealth application for therapy. For this reason, we conducted an expert survey among OMD therapists to gather their input on the LudusMyo prototype. The results of this expert survey are reported in this manuscript.

A habitually open mouth posture leads to less affect strength during joy in childhood

AimCompared with children without orofacial disorders, children with a habitual lack of mouth closure and mouth breathing show less frequent and reduced or absent facial expressions. The facial feedback hypothesis states that affective sensation is enhanced by mimic involvement. In this randomized cross-sectional study with and without orofacially disordered children, we investigated the effect of lack of mouth closure on the strength of emotions related to joy, sadness and fear in children. We aimed to determine whether kindergarten and primary school-age children with a lack of mouth closure are less emotionally involved.Materials and MethodWe used facial feedback as an indicator to measure affect intensity in children with and without orofacial disorders. For this purpose, we modified the experimental design of Strack et al. (Strack et al. in J Pers Soc Psychol 54:768–777, 1988), in which the subjects were asked to hold a pencil exclusively with their teeth (experimental group 1, “joy”), with their lips (experimental group 2, “sadness” and “fear”) or with their nondominant hand (control group). Instead of cartoons, ten medium-funny animal pictures were presented individually in a predefined order to be judged on a Likert scale. The allocation to the groups was implemented using a randomized procedure, independent of the diagnosis, age and sex of the children. The only exclusion criteria were the presence of surgical scars in the orofacial area and cerebral palsy.ResultsA total of 414 children aged 4 to 17 years were studied for facial feedback, with orofacial disorders such as open mouth posture, tongue thrust, myofunctional disorder, craniomandibular dysfunction (CMD) and speech motor disorders diagnosed in 223 subjects. The significance tests showed that in all age groups, children with orofacial disorders rated the joke content of the animal pictures significantly lower than did children without orofacial disorders (4- to 6-year-olds: p value = 0.01, T value = 2.33, confidence = 99%; 7- to 8-year-olds: p value = 0, T value = 4.98, 100% confidence; 9- to 17-year-olds: p value = 0, T value = 2.87, 100% confidence). This finding indicates that children with a lack of mouth closure and other orofacial disorders not only express less pleasure with the help of facial expressions but also feel less pleasure. Moreover, the experimental setup used in this work, which has been modified for children, can be used to test facial feedback in young subjects.ConclusionIn our study, we focused on the interplay between physical and emotional development in children. If left untreated, children with a lack of oral closure may not only show deviations in the orofacial area later on, but also in their emotionality. We endeavored to highlight the importance of treating children with orofacial disorders at an early age.

The professional interactions between speech language therapist and dentist

Aim: This study investigates the collaborative efforts between speech language therapists and dentists to address the challenges faced by patients with concurrent dental and speech issues. It underscores the importance of understanding the complex interactions within the craniofacial system and its implications for both oral health and communication abilities. Methods: A questionnaire-based research was conducted involving speech language therapists and dentists, using Google Forms as the medium of data collection. This study was disseminated through professional networks, where practitioners provided information on their demographics, practices of collaboration, and the perceived advantages of such interdisciplinary work. All ethical standards were adhered to, ensuring the confidentiality and informed consent of the participants. Results: The findings indicate that dentists, often see first patient visits beyond recommended ages primarily for existing conditions, deviating from preventive norms. About half communicate monthly with speech language therapists, revealing gaps in early care and collaboration. Speech language therapists focus on language disorders and orofacial myofunctional disorders (SMOF), with 37% collaborating frequently with dentists. This interaction highlights the potential for enhanced patient outcomes through interdisciplinary cooperation. Despite these challenges, both groups acknowledged the benefits of their collaborative efforts. Conclusions: The partnership between speech language therapists and dentists represents a vital area of healthcare, aimed at tackling the complex issues of oral health and communication through a multidisciplinary approach. Although obstacles in collaboration were identified, the positive outcomes observed from such partnerships emphasize the importance of developing a unified framework to improve integrated healthcare delivery in the future.

Towards Interdisciplinary Collaboration: Surveying Dentists' and Orthodontists' Perspectives on Orofacial Myofunctional Disorders and Therapy.

Children with malocclusion, combined with orofacial myofunctional disorders (OMDs), show increased risk of developing orthodontic problems and needs later in life. Speech-language therapists typically provide orofacial myofunctional therapy (OMT) after referral by dentists, orthodontists or ENT specialists. Interdisciplinary treatment is often advisable to prevent relapse after orthodontic treatment. OMDs and OMT are often found to be controversial topics by dentistry professionals. This study aimed to investigate self-reported knowledge and attitudes of Flemish dentists and orthodontists towards OMDs and OMT. A survey containing 32 items on demographics, self-reported knowledge of OMDs and OMT, attitudes towards OMDs, OMT, and its use in clinical practice, and referral behaviour was filled out by 48 general dentists (48/79, 61%) and 31 orthodontists (31/79, 39%). The impact of specialization, degree of experience and educational programme was also evaluated. Fifty-six percent of all participants (44/79) reported insufficient to non-existent knowledge of OMT. Nevertheless, the general attitude towards the use of OMT was neutral (47%, 37/79) to (very) positive (48%, 38/79). Although they found correct, evidence-based knowledge on OMDs and OMT important, the majority indicated their formal training did not provide adequate information on OMDs (52%, 41/79) and OMT (62%, 49/79). Specialization showed significant effects, as orthodontists reported themselves knowledgeable on this topic significantly more often than general dentists (p < 0.001), and generally reported a more positive stance towards OMT (p = 0.022). Dentists and orthodontists indicated a general interest in the topic of OMDs and OMT, alongside an overall lack of information provided by formal education. Current findings suggest the necessity of re-evaluating current curricula on OMDs and OMT.

Analysis of prefabricated myofunctional appliances with different overjet and bumper designs: a three-dimensional finite element analysis

BackgroundPrefabricated myofunctional appliance can guide tooth eruption, improve dentition alignment, correct myofunctional disorders and harmful oral habits. However, its application to skeletal discrepancy may result in unsatisfactory tooth inclination. This study aimed to construct a novel appliance with overjet design to avoid this side effect and investigated its shape and mechanical changes under occlusion using three-dimensional finite element method.MethodsWe established three samples of prefabricated myofunctional appliances. The first one was edge to edge without overjet, and the outer shield of both jaws were flattened. The second one was 3 mm overjet with stepped the outer shield. The last one was 3 mm overjet, and the outer shield of both jaws were flatted, which meant the front wall of lower jaw was strengthened with bumper, termed as lower bumper. A complete dentition model was applied to the study. 150 N occlusal force was applied to each type of appliance and the deformation displacement and the changes in stress was recorded.ResultsThe deformation was significant in the incisors regions, especially in the vertical and lateral dimensions. The maximum displacements of 3 mm overjet with step shield group were 7.08 mm (vertical), 3.99 mm (lateral), and 2.90 mm (sagittal), while it decreased to 3.92 mm(vertical), 1.94 mm (lateral), and 1.55 mm (sagittal) in overjet with bumper group. Moreover, the upper molar regions exhibited higher vertical and sagittal displacement in 3 mm overjet with step shield group, which were 3.03 mm (vertical) and 1.99 mm (sagittal), and the bumper design could decrease the maximum displacement to 1.72 mm (vertical) and 0.72 mm (sagittal). In addition, the Von Mises stress of appliances was analyzed, and results indicated that 3 mm overjet with step shield generated higher stress than other groups, with the maximum Von Mises stress was 0.9387 MP, which were 0.5858 and 0.5657 MP in edge to edge group and 3 mm overjet with lower bumper group, respectively.ConclusionThe prefabricated myofunctional appliances may cause deformation during occlusion. Compared to step shield group, the application of lower bumper exhibited better resistance to occlusal force.

3D Printer-Assisted Layered Fabrication of a Novel Appliance for Oral Myofunctional Therapy and Functional Evaluation of Its Effects on Orofacial Muscles During Wear.

Aim Balanced function of the orofacial muscles is important for normal occlusion and dentition; however, patients with malocclusion often present with myofunctional disorder (MFD). Myofunctional therapy (MFT) has received much attention as a method for reducing MFD. Moreover, prefabricated functional appliances (PFAs) have been developed as a method to eliminate abnormal muscle pressure and guide the tongue into the correct position. However, PFAs have disadvantages, such as poor intraoral retention, limited usage time due to discomfort and poor patient compliance, and changes in the axis of the mandibular anterior teeth.Therefore, this study aimed to develop a new custom-made splint-type orthodontic appliance with CAD/CAM technology. Moreover, we evaluated the characteristics of the appliance and conducted functional tests to determine the effects of the appliance on the orofacial muscles and the discomfort associated with its use. Materials and methods Twenty-five volunteers (nine females and 16 males; mean age 28.4 ± 3.4 years) with normal swallowing function were included in the study. Lip-closing strength (LCS), electromyogramduring swallowing, oxygen saturation, and pulse rate were measured and compared when the appliance was not worn and when it was worn. In addition, tongue habits were evaluated, and the maximum tongue pressure was measured when the appliance was not worn. The subjects were asked to answer a questionnaire using a numerical rating scale (NRS) regarding discomfort when wearing the appliance. The evaluation items were swallowing difficulty, speaking difficulty, and breathlessness, which were rated on an 11-point scale ranging from 0 to 10. Statistical tests were conducted using IBM SPSS version 28.0.1 (IBM, Armonk, NY, USA) with the Shapiro-Wilk and Levene's test, followed by the Wilcoxon signed rank sum test. The significance level was set at α = 0.05. The measurement error for each measurement item was evaluated using an intraclass correlation coefficient. Results A new custom-made splint-type orthodontic appliance was fabricated for each subject. The fit and retention of the appliance in the mouth were good when fitted, and a comparison of the functional test measurements of 25 subjects with and without the appliance showed that the LCS decreased significantly (p<0.05) before and after wearing the appliance. However, no statistically significant differences were found for the other items. The Mann-Whitney U test regarding the effects of sex, previous orthodontic treatment, or MFT, and oral habits did not statistically significantly influence the effects of wearing the device. In the NRS results, "difficulty swallowing" was observed in half of the subjects, "difficulty breathing" was rarely observed, and "difficulty speaking" was observed in all subjects. Conclusions A novel custom-made splint-type orthodontic appliance was designed and fabricated using digital workflow and 3D printing technology. This appliance was designed to correct oral habits and was made from a new material classified as a class II medical appliance according to the international harmonized classification.

MODERN TOOLS FOR MYOFUNCTIONAL CORRECTION IN SPEECH THERAPY

This research article aims to review and analyse existing research in this area, identifying major trends and gaps in knowledge, and supports the importance of further research to optimise the diagnosis and modern correction of orofacial and myofunctional disorders in the context of ensuring the full development of speech in children.

Importance of translational research in the study of orofacial myofunctional disorders

Importance of translational research in the study of orofacial myofunctional disorders

Orofacial dysfunction screening examinations in children with sleep-disordered breathing symptoms.

Orofacial myofunctional disorders (OMD) and sleep-disordered breathing (SDB) may present as comorbidities. Orofacial characteristics might serve as a clinical marker of SDB, allowing early identification and management of OMD and improving treatment outcomes for sleep disorders. The study aims to characterize OMD in children with SDB symptoms and to investigate possible relationships between the presence of various components of OMD and symptoms of SDB. A cross-sectional study of healthy children aged 6-8 from primary schools was conducted in central Vietnam in 2019. SDB symptoms were collected using the parental Pediatric Sleep Questionnaire, Snoring Severity Scale, Epworth Daytime Sleepiness Scale, and lip-taping nasal breathing assessment. Orofacial myofunctional evaluation included assessment of tongue mobility, as well as of lip and tongue strength using the Iowa Oral Performance Instrument, and of orofacial characteristics by the protocol of Orofacial Myofunctional Evaluation with Scores. Statistical analysis was used to investigate the relationship between OMD components and SDB symptoms. 487 healthy children were evaluated, of whom 46.2% were female. There were 7.6% of children at high risk of SDB. Children with habitual snoring (10.3%) had an increased incidence of restricted tongue mobility and decreased lip and tongue strength. Abnormal breathing patterns (22.4%) demonstrated lower posterior tongue mobility and lower muscle strength. Daytime sleepiness symptoms were associated with changes in muscle strength, facial appearance, and impaired orofacial function. Lower strengths of lip and tongue or improper nasal breathing were more likely to be present in children with reported sleep apnea (6.6%). Neurobehavioral symptoms of inattention and hyperactivity were linked to anomalous appearance/posture, increases in tongue mobility and oral strength. This study demonstrates a prevalence of orofacial myofunctional anomalies in children exhibiting SDB symptoms. Children with prominent SDB symptoms should be considered as candidates for further orofacial myofunctional assessment.

Barriers and facilitators for dental practitioners in implementing orofacial myofunctional therapy: A scoping review protocol

Purpose: Orofacial myofunctional therapy (OMT) addresses various dental issues and has evolved significantly since its emergence in the early 20th century. Despite its uses and effectiveness, the adoption of OMT among dental practitioners varies with a lack of comprehensive understanding in the field. This scoping review will aim to map the current evidence on OMT in dentistry, with a focus on the perspectives and attitudes of dental practitioners, as well as the barriers to and facilitators of its implementation in clinical practice. Method: The planned scoping review adheres to the JBI methodology for scoping reviews guide, with data sourced from five databases, including MEDLINE, CINAHL, Scopus, Dentistry &amp; Oral Science Source, and Cochrane Library. Inclusion criteria encompass dental practitioners' experiences with OMT, using the PCC mnemonic. Titles and abstracts will be screened by two independent reviewers, followed by full-texts, to identify relevant primary sources. The review will include primary studies of quantitative, qualitative, and mixed-methods nature, and is limited to English-language publications. Data will be extracted by two independent reviewers and combined. The extracted data will be analyzed and displayed in a tabulated format, supplemented with a descriptive summary. Conclusion: This scoping review will provide an understanding of the role of OMT in managing orofacial myofunctional disorders and other dental conditions. It seeks to identify barriers and facilitators in implementing OMT, aiming to guide strategies that encourage its adoption in dental practice. The findings are expected to contribute to integrating OMT into standard dental care as appropriate according to local regulations, enhancing the management of dental conditions and improving overall oral health outcomes.

Sleep habits and orofacial myofunctional self-assessment of children at risk for sleep breathing disorders.

To identify orofacial myofunctional complaints and sleep-disordered breathing and correlate them with sleep habits in childhood. The study included 71 parents/guardians of public school children aged 6 to 11 years. They answered a form with semi-structured medical history questions and the Nordic Orofacial Test-Screening - interview, the Pediatric Obstructive Sleep Apnea Screening Tool Questionnaire, and the Children's Sleep Habits Questionnaire - all of them in their Portuguese/Brazilian versions in an online format. Statistical analyses used Spearman's correlation, setting the significance level at 5%. There were 29 female children (40.8%) and 42 male ones (59.2%), with a mean age of 8.52 years. The study found orofacial myofunctional complaints related to breathing functions (35.2%), chewing and swallowing (32.4%), and deleterious habits (33.8%). All children were at a low risk of sleep-disordered breathing. As for sleep habits, 23 children (32.39%) had a lower total score, whereas 48 children (67.61%) exceeded 41 points. There was a correlation between the risk of sleep-disordered breathing in children with complaints of orofacial myofunctional disorders and poor sleep quality/habits.

Translation and cross-cultural adaptation of the "Protocolo de Avaliação Miofuncional Orofacial MBGR" from Brazilian Portuguese into English.

In health-related research, an increasing number of clinical assessment tools are translated and cross-culturally adapted for cross-national and cross-cultural studies and comparisons. However, when translating and cross-culturally adapting clinical assessment tools for use across new countries, cultures, or languages, we must follow a thorough method to reach semantic, idiomatic, experiential, and conceptual equivalences between translated and original versions. Therefore, in this study, we translated and cross-culturally adapted the Protocolo MBGR (Marchesan, Berretin-Felix, Genaro, and Rehder) from Brazilian Portuguese into English, following international guidelines, and named it "MBGR Protocol." To verify its content validity, we used the Content Validity Index. Results indicated excellent content validity: a Scale-Content Validity Index of 0.96 and 97% of all translation units with an Item-Content Validity Index of 1.00. Also, to prove its face validity and confirm whether it worked in the target population's linguistic-cultural setting, we used it with 35 subjects. Again, results demonstrated excellent face validity: in the pretest, 91% of all translation units were considered comprehensible and clear; in the pilot test, 98% of all translation units were considered comprehensible and clear. Thus, we concluded that the MBGR Protocol is promising to enhance the uptake of studies in Orofacial Myology worldwide and support researchers and health professionals in assessing and diagnosing orofacial myofunctional disorders in children, adolescents, adults, and the elderly. Also, it may support evidence-based practice and assist in standardizing assessment and diagnostic criteria. The MBGR Protocol should have its psychometric properties tested before being used in clinical practice or scientific research. Therefore, future studies are needed, and collaborations among researchers from South and North American countries are encouraged to create an international network and advance with knowledge and skills in the Orofacial Myology discipline.

Orofacial and cervical myofunctional intervention programmes for older adults: A scoping review.

Senescent stomatognathic systems undergo anatomical changes that are not always compensated by physiology due to associated factors such as poorly fitted dentures, dental changes, and clinical conditions that trigger sarcopenia. When these conditions are not properly addressed, they can lead to nutritional deficiencies. Hence, this study aimed to map orofacial and cervical myofunctional intervention programmes for older adults, evaluate the current research in this area, and formulate suggestions for further investigation. Scoping review is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. The EMBASE, LILACS, PubMed/Medline, Scopus, Web of Science, and grey literature databases were systematically searched. Studies addressing therapeutic programmes, myofunctional exercises, and their influence on the stomatognathic system of older adults were included. Studies with populations younger than 60 years, residing in long-term care facilities, homes, or hospital care, and with associated comorbidities were excluded, as well as secondary studies. A total of 3098 studies were retrieved. After applying the eligibility criteria, nine studies were eligible for this review. The nine studies were published in English between 2008 and 2021 in the United States, Japan, and South Korea. The participants' mean ages ranged from 64 to 81 years, with a preponderance of females. Six of the studies divided the sample into intervention and control groups. Two studies referred to programmes to promote oral function through facial expression and tongue muscle exercises, salivary gland massage, and swallowing biomechanics. Seven studies report the positive influence of myofunctional exercises on the stomatognathic system. The mapping concluded that therapeutic programmes, including educational actions, help prevent orofacial myofunctional disorders, and improve the functionality of the stomatognathic system.

A Multidisciplinary Approach to Swallowing Rehabilitation in Patients with Forward Head Posture.

(1) Background and Objectives: The forward head posture (FHP) is characterized by increased extensions of upper cervical vertebrae and flexion of the lower cervical vertebrae and upper thoracic regions, associated with muscle shortening. The compressive loading on the tissues in the cervical spine negatively impacts suprahyoid and infrahyoid muscles and generates increased tension of the masticatory muscles. The tongue has relations with the suprahyoid and the infrahyoid muscles. The pattern of swallowing evolves gradually from birth to the age of four. If this developmental transition does not occur, the result is persistent infantile or atypical swallowing-an orofacial myofunctional disorder with the tongue in improper position during swallowing, causing strain and stress on the jaw, face, head and neck. In FHP, muscles crucial to swallowing are biomechanically misaligned. The lengthening of the suprahyoid muscles necessitates stronger contractions to achieve proper hyolaryngeal movement during swallowing. This study assesses the added benefits of physiotherapy to the traditional myofunctional swallowing rehabilitation for patients with FHP. The underlying hypothesis is that without addressing FHP, swallowing rehabilitation remains challenged and potentially incomplete. (2) Materials and Methods: A total of 61 participants (12-26 years) meeting the inclusion criteria (FHP and atypical swallowing) were divided into two similar groups. Group A attended one orofacial myofunctional therapy (OMT) and one physiotherapy session per week, group B only one OMT session per week, for 20 weeks. Exclusion criteria were as follows: ankyloglossia, neurological impairment affecting tongue and swallowing, cervical osteoarticular pathology, other previous or ongoing treatments for FHP and atypical swallowing. (3) Results: There is a significant improvement in terms of movement and use of the orofacial structures (tongue, lips, cheeks), as well as in breathing and swallowing in both groups. Group A achieved better outcomes as the CVA angle was directly addressed by manual therapy and GPR techniques. (4) Conclusions: The combined therapy proved to be more effective than single OMT therapy.

Myofunctional orofacial examination tests: a literature review

IntroductionMyofunctional orofacial examination (MOE) is an important tool for the assessment of the stomatognathic system and orofacial functions, and the early diagnosis of orofacial myofunctional disorders. Therefore, the purpose of the study is to scan the literature and determine the most preferred test for myofunctional orofacial examination.Materials and MethodsA literature review was conducted to collect information. Pubmed and ScienceDirect database was explored by using keywords gained by MeSH (Medical Subject Headings).ResultsFifty-six studies were retrived from the search and all of the studies were screened and evaluated regarding the subject, aim, conclusions and the orofacial myofunctional examination test they used. It has been observed that traditional evaluation and inspection methods have been replaced by newer and methodological approaches in recent years.ConclusionsAlthough the few tests used differ, 'Orofacial Examination Test With Scores’ (OMES) was found to be the most preferred myofunctional orofacial evaluation method from ENT to cardiology.

Agreement between telerehabilitation and face-to-face orofacial myofunctional assessment in persons with acquired brain injury

ABSTRACT Background and objective Orofacial myofunctional disorders are common in persons with acquired brain injury. A new way for early detection of orofacial myofunctional disorders via information and communication technologies may improve accessibility. The purpose of this study was to evaluate the level of agreement between face-to-face and tele-assessment of an orofacial myofunctional protocol in a sample of persons with acquired brain injury. Methods A masked comparative evaluation was conducted in a local association of patients with acquired brain injury. Twenty-three participants (39.1% female, mean age of 54 years) with a diagnosis of acquired brain injury were included in the study. The patients followed a face-to-face and a real-time online assessment using the Orofacial Myofunctional Evaluation with Scores protocol. This is a protocol for evaluation with numerical scales that assess the physical characteristics and the main orofacial functions of patients including appearance, posture, and mobility of lips, tongue, cheeks, and jaws, respiration, mastication, and deglutition. Results The analysis showed excellent interrater reliability (ρ ≥ 0.85) for all the categories. In addition, most confidence intervals were narrow. Conclusions This study reveals excellent interrater reliability of an orofacial myofunctional tele-assessment in patients with acquired brain injury in comparison with a traditional face-to-face evaluation.