Myofunctional disorder (orofacial)

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Classification according to ICD-10
F82.2 Localized developmental disorder of oral motor skills
  • myofunctional disorder (orofacial)
ICD-10 online (WHO version 2019)

A myofunctional disorder (MFSt) in the facial area is characterized by a muscle imbalance, especially of the tongue and lip muscles, but also other facial muscles. Typical signs are an open mouth, an interdental tongue resting position, an open bite and a forward swallowing pattern (" tongue thrust" ). Often there is also a dyslalia , especially the sibilance .

history

At the transition from the 19th to the 20th century, the scientific focus on the chewing organ, the occlusion and the muscular system of the region moved into the scientific focus. In 1907, the American dentist Edward H. Angle described orthodontic treatments involving pressing the tongue; the phoniatrists Max Nadoleczny and Emil Fröschels saw connections between impaired muscle tone, tooth misalignment and dyslalia in the 1910s. After the Second World War it was mainly American researchers of the "Zungenpressens" the phenomena (thongue thrust) scientifically described and developed therapy concepts. The preoccupation with the clinical picture first found wider distribution within dentistry and especially among orthodontists , until other disciplines, especially phoniatrics and speech therapy (again) addressed the problem diagnostically and therapeutically.

etiology

The following possible causal factors are described in a review work:

Medical relevance

A US study shows that the main symptom, the "tongue thrust", is present in 50% of US 8-year-old children with normal development, but the frontal open bite as the main dental symptom only occurs in about 4% of the children Children up. In this respect, the question is asked whether the symptom is relevant. In the following, however, it is concluded that there is a certain relevance, but that there is only a therapeutic consequence for dysgnathia and dyslalia . There are many studies, mainly from the dental and orthodontic literature, which document the connection of the MFSt with tooth and jaw misalignments and describe a negative consequence also in connection with operations of a progeny . Regarding the second classic impact picture, dyslalia, there are only a few recent studies in connection with an MFSt that do not reveal any different findings compared to those published to date. Recently there have been some publications on “peripheral areas” of an MFSt (patients with cerebral movement disorders) in which a therapeutic improvement of factors such as swallowing, speaking, articulation took place.

Diagnosis

The classic diagnosis is primarily a visual diagnosis. Typical findings are (not all results are always present): open mouth as a result of reduced lip force "pincushion chin" by promoting activity of M.mentalis , interdental tongue rest position forwardly directed movement of the tongue during swallowing (tongue protrusion, tongue thrust ), malocclusions, awkward Tongue motor skills, deformation of the hard palate. There is often an interdental or lateral sibilance and a blurred, poorly formed articulation. To assess the oral swallowing phase, palatography (application of a dye to the surface of the tongue, the contact points on the palate after swallowing are documented) and sonography from the floor of the mouth are used . The earlier used X-ray diagnostics are now obsolete because of the radiation exposure. The diagnosis should, depending on the severity, be carried out on an interdisciplinary basis.

therapy

literature

  • Anita M. Kittel: Myofunctional Disorders - A Guide for Parents and Adults Affected. 2004, Schultz-Kirchner-Verlag (on CD) ISBN 3-8248-0438-7 .
  • Meilinger, Marina: Investigation of selected aspects of myofunctional disorders in preschool age. 1999, Herbert-Utz-Verlag ISBN 978-3-89675-631-2 .
  • Daniel Garliner: Myofunctional therapy in practice - disturbed swallowing behavior, disturbed facial muscles and the consequences - diagnosis, planning and implementation of the treatment. 1989. Thieme, Stuttgart. ISBN 978-3-8304-0128-5 .
  • Wolfgang Bigenzahn: Orofacial dysfunctions in childhood - basics, clinic, etiology, diagnosis and therapy. Logopädie Forum at Thieme, Stuttgart 2002. ISBN 978-3-13-100592-2 .

Individual evidence

  1. ↑ EH Angle: malocclusion of the teeth. S. White Manufacturing, Philadelphia. 1907
  2. ↑ M. Nadoleczny: The language and voice disorder in childhood , in: Handbuch der Kinderheilkunde (Ed. M. von Pfaundler). Publishing house FWC Vogel, Leipzig 1912
  3. ^ E. Fröschels: About the relationship of stomatology to speech therapy. Zeitschrift für Stomatologie Vol. 12, pp. 241–262 (1914)
  4. ↑ D. Garliner: The myo-functional therapist. A new member of the dental medicine team. NY State Dent J. 1965 Aug-Sep; 31 (7): 290-6 PMID 5212699
  5. ^ RH Barret, ML Hanson: Oral myofunctional Disorders. CV Mosby Comp., St Louis. 1978
  6. ↑ W. Bigenzahn: Myofunctional disorders of the orofacial region in childhood. Laryngo-Rhino-Otol. 69 (1990) p. 231-236
  7. ↑ RM Mason, WR Proffit: The tongue thrust controversy: background and recommendations. J Speech Hear Disord (1974) 39 (2): 115-132 PMID 4596704
  8. ^ S. Daglio et al .: Changes in orthodontic findings of dyskinesia and dysgnathia under the influence of MFT. ZA Praxis (1990) 8: 282-286
  9. ^ I. Grunert et al .: The effects of myofunctional disorders on the occlusion after progeny operations. Z. Stomatol (1989) 86/7: 451-461
  10. ^ J. Ray: Functional outcomes of orofacial myofunctional therapy in children with cerebral palsy. Int J Orofacial Myology. 2001 Nov; 27: 5-17 PMID 11892371
  11. ^ J. Ray: Effects of orofacial myofunctional therapy on speech intelligibility in individuals with persistent articulatory impairments. Int J Orofacial Myology. 2003 Nov; 29: 5-14 PMID 14689652