Mason Robert M
Department of Communication Sciences and Disorders, University of North Carolina-Greensboro, USA.
Int J Orofacial Myology. 2005 Nov;31:5-14.
Orofacial myofunctional disorders include specific conditions or behaviors that can have a negative impact on oral postures and functions. Historically, interest has focused on behaviors in the horizontal plane, highlighted by tongue thrusting. Currently, the scope of practice also includes tongue forward posturing, lip incompetence, open mouth rest posture, thumb and finger sucking, bruxism, and biting habits involving lips, fingers, tongue and cheeks. The common denominator for myofunctional conditions is a change in the inter-dental arch vertical rest posture dimension, the dental freeway space. The purposes of myofunctional therapy include normalizing the freeway space dimension by eliminating noxious habits or postures related to freeway space change. Improving cosmesis with a lips-together rest posture is also an important treatment goal. The clinical significance of the freeway space is explained in terms of the dental consequences of differential eruption patterns that can develop from postural modification of the freeway space. When the freeway space is opened for extended periods beyond the normal range, the tongue can act as a functional appliance and contribute to the development of anterior open bite or a Class II malocclusion. A clinical procedure is proposed for evaluating the freeway space dimension and incorporating the information into treatment planning and evaluation of treatment success. While dentistry/orthodontics has a primary focus on dental occlusion, or teeth-together relationships, orofacial myologists focus on teeth-apart behaviors and postures that can lead to, or have already resulted in malocclusion.
口面部肌功能紊乱包括可能对口部姿势和功能产生负面影响的特定状况或行为。从历史上看，关注点集中在水平面的行为，以吐舌为突出表现。目前，业务范围还包括舌前伸姿势、唇功能不全、张口休息姿势、吮拇指和吮指、磨牙症以及涉及嘴唇、手指、舌头和脸颊的咬物习惯。肌功能状况的共同特征是牙弓间垂直休息姿势维度的改变，即牙间隙。肌功能治疗的目的包括通过消除与牙间隙改变相关的有害习惯或姿势来使牙间隙维度正常化。通过双唇闭合的休息姿势改善美观也是一个重要的治疗目标。牙间隙的临床意义是根据牙间隙姿势改变可能导致的不同萌出模式的牙齿后果来解释的。当牙间隙在正常范围之外长时间张开时，舌头可起到功能性矫治器的作用，并导致前牙开颌或安氏II类错颌的发生。本文提出了一种临床程序，用于评估牙间隙维度，并将该信息纳入治疗计划和治疗成功的评估中。虽然牙科/正畸学主要关注牙合，即牙齿接触关系，但口面部肌功能治疗师关注的是可能导致错颌或已经导致错颌的牙齿分开的行为和姿势。
