Cayley A S, Tindall A P, Sampson W J, Butcher A R
Orthodontic Department, Perth Dental Hospital, Australia.
Aust Orthod J. 2000 Mar;16(1):23-33.
Myofunctional therapy (MFT) is often prescribed to correct tongue-thrust swallowing, with the expectation that anterior open bite (AOB) will reduce spontaneously if a more posterior tongue posture is learned. However, MFT has not been subjected to systematic evaluation. Electropalatography (EPG), which is used in speech pathology to measure dynamic tongue function for diagnostic, therapeutic and research purposes, is a suitable technique for the evaluation of MFT. This prospective clinical study assessed the effect of tongue re-education therapy on tongue function and dento-facial form in AOB patients. Electropalatography recordings of speech and swallowing, and lateral head cephalometric radiographs were obtained from eight 10-year-old boys with tongue-thrust swallowing behavior and AOB before and after a course of tongue re-education therapy. Although differences in cephalometric measurements before and after therapy were small, there was some evidence of a trend for upper and lower incisor eruption, with concomitant reduction of the AOB. Analysis of the EPG speech data was inconclusive, but the swallowing data showed trends for more consistent and more anterior patterns of EPG contact after therapy. Comparison of pre- and post-therapy EPG data with data from a parallel study using a group of age-matched controls indicated that some "normalisation" of swallowing behaviour had occurred. The results of this research imply that the therapy was partially successful in improving tongue function during swallowing and in reducing AOB. Further research on a larger sample over a longer observation period is required for more accurate assessment of soft and hard tissue changes.
肌功能治疗(MFT)常被用于纠正吐舌吞咽,人们期望如果学会更靠后的舌位姿势,前牙开颌(AOB)会自然减轻。然而,MFT尚未经过系统评估。用于言语病理学中测量动态舌功能以进行诊断、治疗和研究的电子腭图(EPG),是评估MFT的合适技术。这项前瞻性临床研究评估了舌再教育疗法对AOB患者舌功能和牙颌面形态的影响。在一个疗程的舌再教育治疗前后,从八名有吐舌吞咽行为和AOB的10岁男孩身上获取了言语和吞咽的电子腭图记录以及头颅侧位X线片。虽然治疗前后头颅测量的差异很小,但有一些证据表明上下切牙萌出有趋势,同时AOB有所减轻。对EPG言语数据的分析尚无定论,但吞咽数据显示治疗后EPG接触模式更一致且更靠前的趋势。将治疗前后的EPG数据与一项使用一组年龄匹配对照的平行研究的数据进行比较表明,吞咽行为已发生了一些“正常化”。这项研究结果表明,该疗法在改善吞咽时的舌功能和减少AOB方面部分成功。需要在更大样本、更长观察期内进行进一步研究,以更准确地评估软硬组织变化。