Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Ciências Fisiológicas, Piracicaba, SP, Brasil.
Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Fonoaudiologia, Bauru, SP, Brasil.
J Appl Oral Sci. 2018 Feb 1;26:e20170164. doi: 10.1590/1678-7757-2017-0164.
The esthetic and functional results of orthognathic surgery of severe dentofacial deformities are predictable, however there are differences regarding the effects on stomatognathic system. The aim was to investigate the effects of orofacial myofunctional therapy (OMT) on the masticatory function in individuals with dentofacial deformity submitted to orthognathic surgery (OGS).
Forty-eight individuals (18-40 years) were evaluated, 14 undergoing OMT (treated group-TG), 10 without this treatment (untreated group-UTG) and 24 in a control group with normal occlusion; for clinical aspects the data of an individual was missed (n=46). Chewing was performed using the Expanded protocol of orofacial myofunctional evaluation with scores (OMES-E). Muscle tone and mobility were also analyzed before (P0), three (P1) and six months (P2) after OGS. Surface electromyography of the masseter and temporalis muscles was performed, considering the parameters amplitude and duration of act and cycle, and the number of masticatory cycles. The OMT consisted of ten therapeutic sessions along the postoperative period. The results were compared using parametric and non-parametric tests.
TG showed higher scores in P1 and P2 than P0; for the masticatory type the scores in P2 were significantly higher than P0. In addition, the proportion of individuals with adequate tone of lower lip and adequate tongue mobility for TG increased significantly from P1 and P2 in relation to P0. The EMG results showed a decrease in act and cycle duration in P2 in relation to P0 and P1 for the TG; furthermore the values were close to controls. An increase in the number of cycles from P0 to P2 was also observed, indicating faster chewing, which may be attributed to an improvement of balanced occlusion associated with OMT.
There were positive effects of OMT on the clinical and electromyography aspects of chewing in individual submitted to orthognathic surgery.
正颌手术治疗严重牙颌面畸形的美观和功能效果是可预测的，但对口颌系统的影响存在差异。本研究旨在探讨口颌肌功能治疗（OMT）对正颌手术（OGS）患者咀嚼功能的影响。
共评估了 48 名（18-40 岁）个体，其中 14 名接受 OMT（治疗组-TG），10 名未接受 OMT（未治疗组-UTG），24 名正常咬合的个体作为对照组；由于个体数据缺失，实际进行咀嚼评估的个体为 46 名。咀嚼使用口颌肌功能评估扩展方案进行评估，得分（OMES-E）。肌肉张力和运动在 OGS 前（P0）、术后 3 个月（P1）和 6 个月（P2）进行分析。对咀嚼肌（咬肌和颞肌）进行表面肌电图检查，考虑幅度和活动持续时间、周期以及咀嚼周期的数量等参数。OMT 包括术后期间的十个治疗疗程。使用参数和非参数检验对结果进行比较。
与 P0 相比，TG 在 P1 和 P2 时的得分更高；在咀嚼类型方面，P2 的得分明显高于 P0。此外，与 P0 相比，从 P1 和 P2 开始，TG 中下唇和舌移动性适中的个体比例显著增加。EMG 结果显示，与 P0 和 P1 相比，TG 在 P2 时活动和周期持续时间减少；此外，这些值与对照组接近。还观察到从 P0 到 P2 的咀嚼周期数增加，这表明咀嚼速度加快，这可能归因于 OMT 与平衡咬合的改善有关。
OGS 患者接受 OMT 对口颌咀嚼的临床和肌电图方面具有积极影响。
