Stefani Cristine M, de Lima Adriano de Almeida, Stefani Fabiane M, Kung Janice Y, Compton Sharon, Flores-Mir Carlos
Universidad Federal de Brasilia, Department of Dentistry, University of Brasilia, Campus Universitário Darcy Ribeiro, Brasilia, Federal District, Brasilia 70910-900, Brazil.
Universidad Federal de Santa Catarina, Department of Speech, Language and Hearing, Federal University of Santa Catarina, R. Eng. Agronômico Andrei Cristian Ferreira, s/n - Trindade, Florianópolis, Santa Catarina, Florianopolis 88040-900, Brazil.
Eur J Orthod. 2025 Apr 8;47(3). doi: 10.1093/ejo/cjaf024.
Orofacial myofunctional disorders (OMDs) are conditions or behaviors that negatively affect oral postures and functions. These behaviors can interfere with normal orofacial growth and development and related functions.
Map the available evidence regarding the effectiveness of Orofacial Myofunctional Therapy (OMT) in treating or managing OMDs associated with specific malocclusion traits or orthognathic surgery outcomes.
An experienced librarian developed a comprehensive search strategy for six databases and gray literature. The reference lists of included studies were reviewed.
Randomized controlled trials and non-randomized studies of intervention were included in which individuals with OMDs were treated with OMT, regardless of the healthcare setting or the professional delivering the treatment.
Two independent reviewers screened the retrieved records in two phases based on predefined eligibility criteria and extracted data. The evidence level was assessed using the Oxford Levels of Evidence.
Twenty-four studies were included (18 primary studies and 6 reviews). Seven studies focused on OMDs associated with malocclusion sagittal characteristics (Class I, II, or III), ten examined open-bite-related OMDs, and seven explored OMDs following orthognathic surgery. Only four studies (22%) were randomized controlled trials (RCTs); most studies lacked proper randomization procedures, did not report allocation concealment, and three of the four RCTs were open-label. Among the six comparisons identified, five were deemed plausible (four with a level of evidence 3 and one with a level of evidence 2). No comparisons were rated at level 1 evidence. As a result, the effectiveness of OMT alone or in combination with orthodontic treatment for the conditions of interest could not be conclusively confirmed. Further well-designed RCTs are needed to confirm or refute this finding and to strengthen the overall evidence base.
Although no high-level evidence currently supports the effectiveness of OMT for managing OMDs associated with malocclusion traits, its potential effectiveness remains plausible. Level 2 evidence suggests that OMT may effectively manage OMDs following orthognathic surgery.
Open Science Framework (DOI 10.17605/OSF.IO/M6HNS).
口面部肌功能紊乱（OMDs）是对口部姿势和功能产生负面影响的状况或行为。这些行为会干扰正常的口面部生长发育及相关功能。
梳理有关口面部肌功能治疗（OMT）在治疗或管理与特定错颌特征或正颌手术结果相关的OMDs方面有效性的现有证据。
一位经验丰富的图书馆员为六个数据库和灰色文献制定了全面的检索策略。对纳入研究的参考文献列表进行了审查。
纳入随机对照试验和非随机干预研究，其中OMDs患者接受OMT治疗，无论医疗环境或提供治疗的专业人员如何。
两名独立评审员根据预先确定的纳入标准分两个阶段筛选检索到的记录并提取数据。使用牛津证据等级评估证据水平。
纳入了24项研究（18项原始研究和6项综述）。7项研究聚焦于与错颌矢状特征（I类、II类或III类）相关的OMDs，10项研究考察了与开颌相关的OMDs，7项研究探讨了正颌手术后的OMDs。只有4项研究（22%）是随机对照试验（RCTs）；大多数研究缺乏适当的随机程序，未报告分配隐藏情况，4项RCT中有3项是开放标签的。在确定的6项比较中，5项被认为是合理的（4项证据等级为3，1项证据等级为2）。没有比较被评为1级证据。因此，无法确凿证实OMT单独或与正畸治疗联合对相关病症的有效性。需要进一步设计良好的RCT来证实或反驳这一发现，并加强整体证据基础。
虽然目前没有高级别证据支持OMT对管理与错颌特征相关的OMDs的有效性，但其潜在有效性似乎合理。2级证据表明，OMT可能有效管理正颌手术后的OMDs。
开放科学框架（DOI 10.17605/OSF.IO/M6HNS）。
