Impact of myofunctional therapy on orthodontic management and orthognathic surgery outcomes: a scoping review.

BACKGROUND

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.

OBJECTIVES

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.

SEARCH METHODS

An experienced librarian developed a comprehensive search strategy for six databases and gray literature. The reference lists of included studies were reviewed.

SELECTION CRITERIA

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.

DATA COLLECTION AND ANALYSIS

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.

RESULTS

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.

CONCLUSION

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.

REGISTRATION

Open Science Framework (DOI 10.17605/OSF.IO/M6HNS).