Follow-up study of dysgnathia brought about by dyskinesia following myofunctional therapy

Abstract

Forty-eight patients with dysgnathia brought about by tongue dyskinesia underwent myofunctional therapy leading up to and at the beginning of orthodontic treatment. Short- and long-term results of this therapy were studied with the help of indirect palatography. Palatographs of empty swallowing and the test consonants "L", "N", "S" and "T" were evaluated visually and metrically. The palatographs were made prior to myofunctional therapy and thereafter first at the end of the therapy, then at the end of the control or supervision period, and finally, after on average 4 years. Visual evaluation revealed a clearly recognizable change in all functions when compared with the physiological palatographs. A change in the "S" consonant sound was the least conspicuous. Metric evaluation revealed for the 4 out of 5 of the test functions, namely, empty swallowing and the consonants "L", "N", and "T", marked long-term dorsal orientation of the tongue. The short-term changes in tongue function were more prevalent than the long-term.

Validity and Reliability of Logopedic Assessments of Tongue Function

“…Dennoch wurde in zahlreiche Studien gezeigt, dass nach myofunktioneller Therapie nicht nur das Schluckmuster und die Zungenruhelage [6], sondern auch das kieferorthopä-dische Behandlungsziel erfolgreich umgesetzt werden konnte und auch nach Abschluss der kieferorthopädischen Therapie ein stabiles Ergebnis gewährleistet war [12,15,19,35,49]. Dies lässt zumindest den Schluss zu, dass auch in Ermangelung eines "wasserdichten" Befundes zur Zungenfunktion eine Verbesserung der Zungenmotilität durch myofunktionelle Übungen und die Bewusstmachung einer korrekten Zungenposition möglichst ohne Kontakt zu Zähnen Erfolg versprechend sein kann.…”

“…Nevertheless, numerous studies have shown that after myofunctional therapy, not only swallowing pattern and tongue resting position [6], but also the orthodontic treatment objectives were successfully achieved and that a stable result was guaranteed even after completion of orthodontic therapy [12,15,19,35,49]. This at least permits the conclusion that even if there is no "watertight" evidence on tongue function, improvement in tongue motility may lead to success as a result of myofunctional exercises and sensitizing the patient about correct tongue position with as little contact as possible to the teeth.…”

Comparison between Logopedic and MRI Findings in Evaluating Tongue Function

“…The marked drop in agreement as the number of Kittel variables available for diagnosis increases (two-value [kappa = 0.264; p = 0.028] and four-value [kappa = 0.052; p = 0.672] findings sheet) reveals the difficulty of choosing specific criteria for the relevant tongue position (Tables 2a and 2b). In the literature, however, there are numerous diagnostic criteria which are supposed to enable the examiner to diagnose tongue dysfunction definitely and treat it promptly [13,16,42,48]. In this context, Fraser [8] describes the numerous diagnostic terms describing tongue dysfunction.…”

“…There is a proven causal relationship between tongue dysfunction and certain dentofacial deformities [3,14,48]. Although the exact mechanisms of this interaction require further clarification and many authors have been unable to confirm these interrelationships [28,29], incisor protrusion and infraposition, open bite, crossbite and relative mandibular prognathism are considered to correlate with various kinds of tongue dysfunction [6,36,40].…”

“…Eine kausale Beziehung zwischen Zungendysfunktionen und charakteristischen Dysgnathien gilt als erwiesen [3,14,48]. Obwohl die genauen Mechanismen dieser Wechselwirkung weiterer Klärung bedürfen und manche Autoren diese Zusammenhänge nicht bestätigen konnten [28,29], werden die Protrusion und die Infraposition von Schneidezähnen, ein offener Biss, ein Kreuzbiss und eine relative mandibuläre Prognathie im Zusammenhang mit Zungendysfunktionen gesehen [6,36,40].…”