Persisting orofacial dysfunctions impede the normal development of the orofacial and craniocervical region and reduce the stability of any orthodontic treatment. Myofunctional therapy is a treatment concept to harmonize orofacial function and is conducted by speech therapists. Because of waiting periods before the start of treatment and the duration of myofunctional therapy an overall time period of one to two years must be taken into account between referral and end of myofunctional therapy. Furthermore, individual treatment outcome depends on several factors.
This clinical study was designed to evaluate a new method of treatment with a face former appliance in comparison with myofunctional therapy. Face former therapy can be supervised by the orthodontist. It is a daily exercise program to strengthen orofacial muscle and harmonize function with the face former [Figure 1 and Figure 2 a-c].
Material an Methods
The clinical study comprised 45 children aged 5-12 years with orofacial disturbances such as incompetent lip closure, habitual mouth breathing, infantile swallowing pattern, generalized orofacial hypotonicity and sigmatism. Therefore, in all children myofunctional therapy was indicated. The children were randomly divided into two groups: 17 children were referred to myofunctional therapy in private practices in Hamburg and served as controls. The remaining 27 children were treated with the face former at the Department of Orthodontics. The overall observation time was nine months.
In all children orofacial function could be improved. Children treated with the face former tended to show a more palatal tongue position during swallowing, a stronger lip pressure and a habitual mouth closure than children with myofunctional therapy. The specific results were as followed:
Changes of the respiratory pattern were not statically significant in the control group. In the study group the improvement of the respiratory pattern was statistically high significant.
The swallowing pattern was determined with the help of palatography. Although not all children reached a physiological swallowing pattern at the end of the observation time, the harmonizing of the swallowing pattern was highly statistically significant in the face former group. Improvements in the myofunctional therapy group were not statistically significant.
Improvement of lip strength was highly statistically significant in both groups. Children with the face former therapy reached the improvement within a shorter period of time.
In both groups in some children sigmatism could be corrected, but the observed improvements were not statistically significant.
Therapy with the face former seems to be a good alternative to myofunctional therapy. Longitudinal studies will follow to judge if the established orofacial balance could be automised. Both treatment concepts did not succeed in the correction of sigmatism. Additional speech therapy has to be initiated.
B. Kahl-Nieke, H. Korbmacher, S. Berndsen, M. Schwan, J. Bull
From the Department of Orthodontics of the Center for Oral, Maxillofacial and Maxillofacial Surgeons, University Hospital Hamburg-Eppendorf, Director: Prof. Dr. med. Dent. B. Kahl-Nieke
The complete study can be found here in the database of the German National Library.