Myofunctional Status Research Articles

Relationship between Occlusal Findings and Orofacial Myofunctional Status in Primary and Mixed Dentition

The aim of this study is to provide basic data on the prevalence of malocclusions and orofacial dysfunctions in the primary and early mixed dentition, to examine occlusal relationships in their functional context, and to analyze the need for and potential of orthodontic prevention. Occlusal relationships and myofunctional status were evaluated in 766 children in the primary dentition and in 2,275 children in the early mixed dentition. Orthodontic findings in single jaws and intermaxillary occlusal relationships were clinically analyzed in all three dimensions. Normal occlusal relationships were found in 25.3% of children in the primary dentition. Frequency of children with normal dentitions fell significantly in the mixed dentition (7.3%). Prevalence of bilateral distoclusion increased significantly from the primary to the mixed dentition. Increased maxillary overjet was diagnosed in 49.3% and 59.0% of the children in the primary and mixed dentition, respectively. Prevalence of lateral crossbites increased significantly from primary to mixed dentition (7.2% vs. 12.0%). Deep bites and edge-to-edge bites were found significantly more often in the early mixed dentition. The significant increase in the prevalence of malocclusions between the primary and mixed dentition--distoclusion and lateral crossbite, and the impairment of vertical occlusal relationships in the mixed dentition in particular--reveal the need for orthodontic prevention. They highlight the absence of applied interceptive and early treatment measures in orthodontics. The indication system in current use for early orthodontic treatment here in Germany fails to fulfill the requirements for prevention-oriented dental care.

Orofacial myofunctional disorders in children with asymmetry of the posture and locomotion apparatus

352 children radiologically identified with asymmetry in the occipito-cervical region were assessed on a number of myofunctional measures. In all children an orthopedic examination was conducted including a functional test of the upper cervical spine and the iliac joint, the postural test by Matthiass, as well as gait analysis. During a second examination the orofacial myofunctional status was recorded. In general, about 70% of the children revealed orofacial myofunctional disorders. Correlational analysis was conducted in order to determine whether specific myofunctional variables were associated with postural and orthopedic alterations. A weak body posture correlated statistically significantly with all assessed myofunctional variables. On the other hand, all orthopedic items correlated significantly with a reclined head position. A blockade of the iliac spine correlated significantly with persistent habits, articulation disorders and tongue dysfunction, whereas functional asymmetry of the upper cervical spine correlated significantly with incompetent lips. A finding of at least five statistically significant correlations within each orofacial variable underlined the complex symptomatology of myofunctional disorders, so that consideration needs to be given to adequate treatment approaches. The data generated by the present study stress the importance of early interdisciplinary screening in children to ensure a physiological development of the orofacial region and the still growing vertebral column. To help understand the complexity of symptoms influencing orofacial development, an explanatory model of the “interactive functional box system” is given.

Myofunctional evaluation after surgery for tonsils hypertrophy and its correlation to breathing pattern: A 2-year-follow up

To evaluate the myofunctional status in children submitted to adenoidectomy or adenotonsillectomy, correlating the pre and post-surgical patterns throughout a 24-month-period. To correlate the myofunctional alterations to the sort of surgery performed (adenoidectomy versus adenotonsillectomy) and to the predominant post-surgical breathing pattern (predominantly nasal versus allergic rhinitis). Forty children were assessed by the otorhinolaryngologist and speech therapist before and 1-24 months after surgery. In order to evaluate myofunctional status, a pre-structured protocol was designed, which included observations regarding facial posture, tonicity, mastication, deglutition and respiration. A score from 0 (normal pattern) to 12 (highly altered) was set. There was a partial, but progressive decrease of the score after surgery (p < 0.001). This decrease was markedly observed during the first 6 months following surgical procedure (p < 0.001), after which it was no longer significant. There was no correlation between the myofunctional progress and the sort of surgery performed. The myofunctional improvement was more accentuated in nasal breathers when compared to those with allergic rhinitis. Improvement of myofunctional status seems to be observed in children after surgery. In this study, the improvement was predominantly accomplished during the first 6 months following surgical procedure. Persistent pattern of mouth breathing due to allergic rhinitis may difficult recovery of the myofunctional status. The most adequate post-surgical moment for the otorhinolaryngologist to refer the patient to speech therapist for myofunctional therapy seems to be crucial, as well as the recognition by the speech therapist of the persistence of the obstructive symptoms, re-referring this patient to the physician.