This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
La collaboration de l’orthodontiste, de l’occlusodontiste et du kinésithérapeute à la prise en charge des patients souffrant de dysfonctionnements temporomandibulaires (DTM) est essentielle. La rééducation myofonctionnelle orofaciale (RMOF) est une modalité thérapeutique conservatrice, simple et réversible. Son indication est justifiée par le large consensus qui émane des données actuelles fondées de la littérature scientifique.
Les objectifs de cet article sont de présenter les indications de la rééducation myofonctionnelle orofaciale dans la prise en charge des DTM et de montrer comment l’intégrer dans une démarche planifiée d’éducation thérapeutique du patient (ETP). Seront également exposées les données de la littérature évaluant l’efficacité de la RMOF, les données de neurosciences et de physiopathologie expliquant son mode d’action, ainsi que les exercices spécifiques pour le cou et le dos.
Background
Temporomandibular disorder (TMD) perturbs the tongue motor control and consequently impairs oral function, but strength training reduces this impairment. However, tongue motor control is widely reduced to a matter of strength.
Objectives
To investigate the accuracy of the tongue placement as a measure of tongue motor control in patients with TMD compared with age‐ and sex‐matched healthy participants.
Material and Methods
This proof‐of‐concept case‐control study was prospective, observational, and part of the TMIQ study (NCT04102306). After pointing against a wood stick while maintaining the tongue as sharp as possible, the examinator drew the contour of the tongue print on the wood stick, which was then scanned for image analyses to compute the area for each participant using ImageJ.
Results
A total of 94 participants were included, all patients with TMD (
n
= 47) diagnosed with myalgia, 61% with intra‐articular joint disorder accordingly to the DC/TMD. The median (IQR) tongue print area was 117 (111) mm
2
for the TMD group and 93.5 (76.2) mm
2
for the control group (
V
= 352,
p
= .04) and the median [95% confidence interval] difference was 25.4 [1.3; 51.0] mm². Overlapping of the 95% confidence intervals of the area evidenced no significant difference between the categories of the DC/TMD. The corrected each area–total correlation (
r
= .24) suggests a reasonably homogenous thus valid measure.
Conclusion
The results suggest that TMD impairs the motor control of the tongue. Therefore, the sharpest tongue pointing test may constitute a simple and accessible clinical tool to assess the accuracy of tongue placement in TMD patients. The study was registered on
ClinicalTrial.gov
with identification number NCT04102306.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.