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INTERNATIONAL JOURNAL OF OROFACIAL MYOLOGYEditorial Staff
Patricia Taylor M.Ed.
Editor-in-Chief
Bloomburg, Pennsylvania
Associate Editors
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Angela Dikengil, MS
Finance
Peer ReviewBoard
Morris Plains. NJ
Robert Grider, MA
Peer Review Board
Maple Grove, MN
Monique Kaye, MS
Subscriptions
Peer Review Board
Watchung, NJ
Dianne Lazer. MA
Peer Review Board
Voorhees,NJ
Robert M. Mason, DMD,Ph.D
Peer Review Board
Durham, NC
Betty Jo Morris
Editorial Review
Sayre,PA
Nancy Pearl Solomon, Ph.D
Peer Review Board
Washington, DC 20307
Samantha Taylor, BBS
Peer Review Board
Long Island
Jayanti Ray, Ph.D.
Peer Review Board
Cape Girardeau, MO
Joseph B. Zimmerman, M.Ed, COM
Peer Review Board
Redmond, WA
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Official Publication of the International Association of Orofacial Myology
Presentation of information in these issues of IJOM does not imply endorsement of the products, Philosophy, or theories, advanced by the authors. It is the intent of IJOM to provide ideas, methods, materials,equipment and points of view that may be presented to orofacial myologists for the advancement of knowledge. We recognize that some of these ideas, techniques and materials may be considered controversial or experimental in nature. The fact that these articles are presented in these issues does not necessarily constitute endorsement or approval by IAOM or IJOM. Research results, opinions and statements made in articles contained in IJOM are those of the authors. Accurate referencing/citations is the responsibility and/or liability of the authors. IJOM it's editorial staff and the IAOM Board/publishers disclaim responsibility and/or liability for information contained, and the inaccurate, incomplete, or omitted citations in this Journal and shall not be liable for any injury or harm resulting from the use of information contained.
INTERNATIONAL JOURNAL OF OROFACIAL MYOLOGYVolume XXXII
November 2006
OCCLUSAL AND OROFACIAL MYOFUNCTIONAL EVALUATION IN CHILDREN WITH PRIMARY DENTITION, ANTERIOR OPEN BITE AND PACIFIER SUCKING HABIT
Anna Paula Verrastro, DDS, MSc, Fabiane Miron Stefani,SpeechTherapist,MSc
Celi'a Regina Martins Delgado Todriques, DDS, MSc, PhD,
Marcia Turolla Wanderley, DDS, MSc, PhD
ABSTRACT: The aim of this study was to evaluate occlusal and orofacial myofunctional characterteristics in children three to five years with anterior open bite related to a pacifier sucking habit. Sixity-nine children participated in this study: 35 with anterior open bite (Anterior Op en Bite Group - AOBG) and 34 with normaal occulusion(Control Group - CG). In AOBG, the mean anterior open bite was 2.96 mm, the mean overjet was 2.6 mm and the upper intercanine distance was 28.7 mm. In The CG, the mean overjet was 2.6 mm and the upper intercanine distance 30.3 mm. The mean overjet was greater (p=0.001) in AOBG than in CG, and the mean upper intercanine was smaller (p<0.001) in AOBG. The number of children with a canine Class II relationship was greater in AOBG than in CG(p<0.001). Simple logistic regression analysis showed that greater over jet, smaller upper interncanine distance and class II canine relationship coexisted with anterior open bite. In AOBG the number of children with incompetent lips, inadequate lip tonus, lack of proper tongue rest position, inadequate cheek tonus, anterior tongue interposition during swallow and speech was greater(p<0.05) than in CG. Multiple logistic regression analysis identified anterior tongue interposition during swallow and speech, as well as incompetent lips, as the main orofacial myofunctional characteristics in children with anterior open bite.
Keywords: Sucking habits; Pacifier sucking; Dental arch; Primary dentition; Anterior open bite; Stomatognatic System
OROFACIAL MYOFUNCTIONAL DEFICITS IN ELDERLY INDIVIDUALSJayanti Ray, Ph.D
ABSTRACT: Orofacial myofunctional deficits in elderly individuals impact nutrition, swallowing, speech, quality of life, and other aesthetic functions. This paper explores briefly the common orofacial myofunctional disorders (OMD) due to various etiologies. Ideally, the available evidence suggests that an interdisciplinary team should be able to diagnose and document effectively the OMD and provide evidence-based services to the clientele.
Keywords: Orofacial Myofunctional Disorders; Elderly Population; Swallowing
CASE PRESENTATION: DENTAL TREATMENT
WITH PAP FOR ALS PATIENTTakeshi Kikutani, D.D.S., Ph.D., Fumiyo Tamura, D.D.S., Ph.D.,
Keiko Nishiwaki, S.L.P
ABSTRACT: The aim of this study was to evaluate the effect of Palatal Augmentation Prosthesis (PAP) for an Amyotrophic Lateral Sclerosis (ALS) patient. The patient's palatogram was taken during swallowing to assess her lingual function. A PAP was provided to assist her with feeding and swallowing functions. The patient's lingual pressure strength showed increases, and she was able to feed well using PAP. This devise was useful for assisting lingual dysfunctions due to various diseases.
Keywords: Orofacial Myofunctional Disorders, Amyotrophic Lateral Sclerosis, Palaral Augmentation Prothesis, Lingual Function
INSTRUMENTATION AND MEASUREMENT PROCEDURES IN OROFACIAL MYOLOGY
Licia Coceani Paskay, MS, CCC-SLP, COM
ABSTRACT:
The article describes measuresments and measuring devices as they apply to assessment, therapy and research in orofacial myology and myofunctional therapy. Although the list is by no means complete, a wide range of terms, their objectility, complexity, applicability and accuracy is presented.
Keywords:
Measurements; Measuring Devices; Orofacial Myology; Myofunctional Therapy
THE IMPORTANCE OF CHOOSING THE RIGHT FEEDING AIDS TO MAINTAIN BREAST-FEEDING AFTER INTERRUPTIONAntonio Ferrante, MD, DDs, Raffaele Silvestri, MD, Carlo Montinaro, MD
ABSTRACT: Publications throughout the world attribute to the artificial teat and the pacifier (dummy) the reason why some mothers, who suspend breast-feeding for a while, are unable to resume it afterwards. The authors wanted to evaluate the specific characteristics of such commercially available teats and pacifiers. It has been possible to affirm that the specific features of the various teats tested are important in the resumption of breast - feeding after interruption. It's easier to resume breast-feeding interruption if artificial teats are prescribed with an understanding of the muscular movements during swallowing.
Keywords: Bottle feeding, Pacifiers, Dummies, Orofacial Myology, Swallowing
INTERNATIONAL JOURNAL OF OROFACIAL MYOLOGYVolume XXXI
November 2005
A RETROSPECTIVE AND PROSPECTIVE
VIEW OF OROFACIAL MYOLOGY
Robert M. Mason, D.M.D., Ph.D.
ABSTRACT:
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, bruxisom, and biting habits involving lips, figures, 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 myofunstional therapy include normalizing the freeway space dimension by eliminating poxious habits or postures related to freeway space change. Improving cosmetics 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 of 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.
KEY WORDS: Freeway space, Myofunctional disorders, Scope of practice, Functional appliance, Clinical assessment
REPEATED TONGUE AND HAND STRENGTH MEASUREMENTS IN NORMAL ADULTS AND INDIVIDUALS WITH PARKINSON'S DISEASECarol O'Day, Ph.D. Elaine Frank, Ph.D.,
Allen Montgomery, Ph.D., Michele Nichols, M.S., Hiram McDade, Ph.D.
ABSTRACT:
Changes in tongue and strength measurements if men with Parkinson's Disease and aged-matched controls across multiple days were examined. The Iowa Oral Performance Instrument measured tongue and hand strength during four consecutive days and at day 11. Peak tongue strength measurements occurred on day 3 with a small decrease on day 4, which was maintained at day 11, indicating a significant increase in tongue strength measurements with task repetition in multiple days. No change in hand strength measurements was noted over days. Significant differences in mean tongue and hand strength measurements between the PD and age-matched control group were found. Tongue and hand strength measurements were lower for the
PD group compared with the control group on average across days.
KEY WORDS: Tongue, Hand, Parkinson's Disease
OROFACIAL MYOFUNCTIONAL DISORDERS IN CHILDREN WITH ASYMMETRY OF THE POSTURE AND LOCOMOTION APPARATUS
Heike Korbmacher (Dr. Med./Dent.), Lutz E. Koch (Dr. Med./Dent.) Barbel Kahl-Nieke, (Dr. Med./Dent./Ph.D.)
ABSTRACT: 352 children radiologically identified with asymmetry in the occipito-cervical region were assessed on a number of myofunctional measures. In all children an orthopedic examination was conducted including a functional test of the upper cervical spine and the iliac joint, the posturual test by Matthiass, as well as gait analysis. During a second examination the orofacial myofunctional status was recorded. In general, about 70% of the children revealed orofacial myofunctional disorders. Correlational analysis was conducted in order to determine whether specific myofunctional variables were associated with postural and otheropedic alterations. A weak body posture correlated statistically significantly with all assessed myofunctional variables. On the other hand, all orthopedic items correlated significantly with a reclined head postion. A blockade of the iliac spine correlated significantly with persistent habits, articulation, disorders and tongue dysfunction, whereas functional asymmetry of the upper cervical correlations within each orofacial variable underlined the complex symptomatology of myofunctional disorders, so that consideration needs to be given to adequate treatment approaches. The data generated by the present study stress the importance of early interdisciplinary screening in children to ensure a physiological development of the orofacial region and the still growing vertebral column. To help understand the complexity of symptoms influencing orofacial development, an explanatory model of the "interactive functional box system" is given.
KEYWORDS: Orofacial myofunctional disorders, Reclined head postions. Weak body posture, Interactive functional box system
LINGUAL FRENULUM: QUANTITATIVE EVALUATION PROPOSAL
Irene Queiroz Marchesan, Ph.D.
ABSTRACT: The purpose of this study was to establish a quantitative method to classify lingual frenulum as normal and altered. Methods: 98 people were included in this study. All measurements were made with maximum opening of the mouth. A digital caliper was used to measure the length of the frenulum under three conditions; a) with the tongue tip on the incisal papilla; b) with the tongue sucked up and maintained against the hard palate; and c) with tongue stretching over the spatula. Results: observations indicated that the most useful and statistically significant way of measuring frenulum length was achieved with maximum mouth opening and the tongue tip on the incisal papilla. Conclusion: this quantitative method was demonstrated to be effective for identifying and distinguishing normal and altered frenular length .KEYWORDS: Lingual frenulum; Tongue/physiology; Tongue diseases; Speech disorders; Quantitative evaluation
INTERNATIONAL JOURNAL OF OROFACIAL MYOLOGY
30th ANNIVERSARY EDITIONVolume XXX
November 2004
ASSESSMENT OF TONGUE WEAKNESS AND FATIGUE
Nancy Pearl Solomon, Ph.D., CCC-SLP
ABSTRACT: Assessment of nonspeech tongue function is common in speech-language pathology. This paper reviews techniques used to determine tongue strength and endurance, and describes a constant-effort task. These techniques are intended to reveal and quantify the presence of weakness or fatigue of the tongue. The consequences of performing these tasks with and without a bite block, used to fix jaw position, are considered. Whether nonspeech tongue impairment is associated with speech dysfunction in Parkinson's disease is another topic of interest. Past studies indicated reduced tongue strength and endurance in Parkinson's disease, but these measures did not correlate with speech measures. It was hypothesized that weakness and fatigue need to be impaired to a "critical" level before speech is perceptibly affected. To examine whether experimentally induced tongue fatigue affects speech, normal speakers performed prolonged strenuous tongue exercise. Speech deteriorated following these exercises. A new investigation examines whether 1 hour of speech like tongue exercise (rapid syllable repetitions) affects dysarthric speech. Preliminary data from 6 participants with Parkinson's disease, 1 person with bulbar ALS, and 6 neurologically normal control subjects indicate that sentences sound more precise but less natural after the exercises. Surprisingly, results did not differ significantly between the groups. Continued collection of data and refinement of tasks will contribute to our understanding of the potential relations between weakness, fatigue, and speech.
KEY WORDS: Tongue strength, Endurance, Effort, Bite blocks, Parkinson's Disease, Disarrays
THE ROLE OF ANIMAL MODELS IN UNDERSTANDING FEEDING BEHAVIOR IN INFANTS
R.Z. German Ph.D.,
A.W. Crompton, D.Sc., Ph.D., A.J. Thexton, Ph.D.
ABSTRACT: The common evolutionary history humans share with mammals provides us with a solid basis for understanding normal oropharyngeal anatomy and functions. Physiologically, feeding is a cycle of neurophysiologic activity, where sensory inputs travels to the CNS which sends motor signals out to the periphery.
Research with animal models is valuable because it is possible to disrupt this cycle, and develop predictive models on the casual basis of deviation from normal. Based on work with animal models, normal mammalian infant feeding behavior consists of the tongue functioning as a pump. First, the tongue assists in acquisition of milk from the nipple into the oral cavity into the valleculae prior to the pharyngeal swallow. Starting with this basic, feeding in infant pigs was manipulated to determine the impact of variation in sensory input on behavioral output. One set of experiments suggested that chemo-or liquid sensation, in the form of milk is necessary to elicit continuing rhythmic activity. However, rates of rhythmic sucking are intrinsic to an animal, and variation in the rate cannot be entrained. Another set showed that initiation of the swallow does not purely depend on the volume of milk delivered, but also on the sensory stimulation at the mouth. These results support the idea that feeding behavior involves complex sensory integration.
KEY WORDS: Animal models, Feeding behavior, Infant
LINGUAL FRENULUM:
CLASSIFICATION AND SPEECH INTERFERENCE
Irene Queiroz Marchesan Ph.D., SLP
ABSTRACT:
Purpose: To propose a classification of the different lingual frenulum and to relate them to speech disorders. Methods: We evaluated 1402 patients' frenulum with an age range of 5 years 8 months to 62 years 10 months between 1978 and 2002. Pictures were taken of the altered frenulum. Measures of maximal mouth opening, with and without tongue suction, were taken with a sliding caliper. Speech samples were also taken. Frenulum were then classified as normal; short; with anterior insertion, and short with anterior insertion. Results: From the 1402 patients evaluated, 127(9%) presented with an altered frenulum insertion. For this study we considered only those with short or with anterior insertation. For those who had an altered frenulum, 62(48.81) presented with speech disorders. The most frequent speech disorders were: omission and substitution of/r/;(R), and consonant clusters with/r/, and of /s/ and/z/. Frontal and lateral lisps also occurred. The frenulum of 21 patients was classified as short and of these 12 patients(57%) presented with speech disorders. Of the 106 patients with anterior insertation, 50(47.2%) presented with a speech disorder. After statistical analyses the relation between altered frenulum and speech disorders was considered significant with p<0.001. Conclusion: The lingual frenulum was classified as normal, short and with anterior insertation. An altered frenulum may predispose the individual to exhibit an accompanying speech disorder.
KEY WORDS: Lingual frenulum; Tongue physiology; Speech disorders
EVALUATION OF A NEW CONCEPT OF MYOFUNCTIONAL THERAPY IN CHILDREN
Heike M. Kormacher, (Dr. Med.), Marco Schwan, Sabine Berndsen, Julia Bull, (Dr.Med./Dent.), Kahl-Nieke, (Dr. Med./Dent./Ph.D.)
ABSTRACT:
This prospective study was designed to evaluate a new concept of myofunctional therapy in comparison with conventional myofunctional therapy. 45 children aged three to sixteen years of age in need of myofunctional therapy were randomly divided into two groups: 19 children were referred to myofunctional therapy in private practices in Hamburg and served as controls. The remaining 26 children were treated with face former therapy at the Department of Orthodontics by a medical assistant specializing in myofunctional therapy. The overall observation time was six months. Every three months an overall clinical assessment was performed at the Department of Orthodontics by a speech pathologist and an orthodontist, who documented the clinical situation. The clinical examination included measurement of lip strength, palatography to document the swallowing pattern, logopedic diagnosis, and an orthodontic evaluation with a reference to a standardized diagostic sheet. In all the children's orofacial functions could be improved. Children treated with the Face Former showed a statistically significantly improvement in the palatal tongue position during swallowing. They achieved stronger lip pressure within a shorter time than children who did not use the Face Former. However, at the end of the observation time there was no statistically significant difference in lip strength between the two groups. Habitual mouth closure was also achieved within a shorter time with children treated with the Face Former than children with myofunctional therapy. Longitudinal studies will follow to judge whether the established orofacial balance could be stabilized, i.e. the established physiological orofacial function becomes automatic.
KEYWORDS: Myofunctional Therapy; Face Former; Swallowing pattern; Mouth breathing; Stigmatis
DISTRIBUTION OF CAUSES AND TREATMENTS OF DYSPHAGIA AT DYSPHASIA/DYSPHAGIA REHABILITATION CLINIC OF SHOWA UNIVERSITY DENTAL HOSPITAL:
1999-2002
Fumiyo Tamura, D.D.S., Ph.D., Rika Ayano, D.D.S., Ph.D., Hiroyuki Haishima, D.D.S., Ryo Ishida, D.D.S., Ph.D.
ABSTRACT:
The purpose of this study was to investigate the distribution of causes of dysphagia and the types of treatments being provided at the Dysphasia/Dysphagia Rehabilitation Clinic of Showa University Dental Hospital. The subjects included 173 dysphagic patients. Fifty-three percent of the patients ranged 0-12 years of age, and 24% of them were over 60 years old. The survey results showed that diseases of the central nervous, such as cerebral palsy(CP), was a major diagnosis in young patients, and cerebrovascular accident (CVA) was a predominant cause in adult and elderly patients. Diagnosis distribution showed that swallowing dysfunction was the most frequent diagnosis for patients on their first visit when compared to other feeding dysfunctions including malfunction of lips, tongue, and mastication. Almost 40% of patients still continue to have rehabilitation for their dysphagic symptoms at the end of March 2002. This suggests that dysphagia rehabilitation is needed for many disabled individuals.KEYWORDS: Swallow-aid; Elderly; Swallowing dysfunction
EARLY LINGUAL FRENECTOMY ASSISTED BY CO2 LASER HELPS PREVENTION AND TREATMENT OF FUNCTIONAL ALTERATIONS CAUSED BY ANKYLOGLOSSIA.
Renata C. Fiorotti, MSc, Milene M. Bertolini, MSc
Jorge H. Nicola, Ph.D., Ester M.D. Nicola, Ph.D.
ABSTRACT: Incorrectly produced speech sounds, the presence of dentofacial alterations and acquired functional adaptations may be due to a short and inadequate lingual frenum. When frenectomy is indicated, it should be performed as early as possible to prevent functional alterations. This study presents a literature review on correct lingual positioning in relation to orthodontic and phonetic function as well as an assessment of 15 patients who underwent frenectomy utilizing the carbon dioxide laser. The results demonstrated that this technique is safe, effective and perfect for use in young children and can be performed in an out patient unit.KEYWORD: Frenectomy, Ankyloglossia, Carbon dioxide Laser
QUESTIONNAIRE:
IAOM'S ROLE IN WORLD WIDE TREATMENT
OF HANDICAPPED PATIENTSDr. Stefano, Dr.ssa Roberta D'Avenia, Patricia Taylor, M.Ed. For additional information, please contact Patricia Taylor at taylor2@intergrafix.net
International Journal of Orofacial Myology
2003 - Volume XXVIV
CONTENTS
Effects of Orofacial Myofunctional Therapy on Speech Intelligibility in individuals with persistent Articulatory Impairments. Jayanti Ray Ph.D.
Oral Structures and Sleep Disorders: A Literature Review. Licia Coceani, MS
Cephalometic Evaluation in Children Presenting Adapted Swallowing During Mixed Dentition.Milene Maria Bertolini, St, Sergio Vilhegas, DS, Denise Yvonne Janovitz Norato, MD, PhD, Jorge Rizzato Paschoal MD,Ph.
Lip Sucking and Lip Biting in the Primary Dentition: Two Cases Treated with a Morphological Approach Combined with Lip Exercises and Habituation. Kyoko Fukumitsu D.D.S., D.D.Sc., Fumie Ohno D.D.S., Toshihide Ohno D.D.S.,D.D.Sc.
Editor's Corner, Patricia M. Taylor M.Ed., C.O.M.
International Journal of Orofacial Myology
Nov 2002 - VOL XXVIII
CONTENTS
Suffer the Little Children: Fixed intraoral Habit Appliances for Treating Childhood Thumbsucking Habits: A Critical Review of the Literature. Nicholas L. Moore. B. Tech.(Hons), inf.Sc.
Orofacial Myofunctional Therapy in Dysarthria: A Study on Speech Intelligibility. Jayanti Ray Ph.D. CCC-SLP
Physiological Effects of a 8-week Mechanically Aided Resistance Facial Exercise Program.Pascal H.H.M. van Lieshout, Arpita Bose, & Aravind K. Namasivayam.
BOOK REVIEW
Patricia M. Taylor
EDITOR'S CORNER
Patricia M. Taylor and Robert M. Mason, DMD,Ph.D
International Journal of Orofacial Myology
Nov 2001 - VOL XXVII
CONTENTS
Functional Outcomes of Orofacial Myofunctional Therapy in Children with Cebebral Palsy. Jayanti Ray Ph.D.CCC-SLP
The Relationship of Lip Strength and Lip Sealing in MFT. Masaru Satomi D.D.S.,Ph.D.
Rationale for Including Orofacial Myofunctional Therapy in University Training Programs. Roberta Pierce, M.A.T., and Patricia M. Taylor M.Ed, C.O.M.
Prevalence of Adapted Swallowing in a population of School Children. Milene Maria Bertolini and Jorge Rizato Paschoal
Orofacial Myofunctional Disorders Related to Malocclusion .Ana Lia Garretto
Editor's Corner. Patricia M. Taylor
International Journal of Orofacial Myology
Nov 2000 - VOL XXVI
CONTENTS
Speech Pathology with Alterations of the Stomatognathic System. Irene Queiroz Marchesan
Relationship Between Mouth Breathing and Postural Alterations of Children: A Descriptive Analysis. Lilian H, Krakauer and Arnaldo Guilherme.
The Development of Normal Feeding and Swallowing: Showa University of the feeding function. Rika Ayano, Fumiyo Tamura, Yoshiaki Ohtsuka, and Youshiharu Mukai.
Assessment of the Development of Hand and Mouth Coordination When Taking Food into the Oral Cavity. Fumiyo Tamura, Akiko Chigira, Hitomi Ishii, Hirokazu Nishikata Mukai.
Tongue Lip and Jaw Differentiation and its Relationship to Orofacial Myofunctional Therapy. Patricia G.Meyer
CLINICAL FORUM
Case Presentation: Resolution of an Oral Lesion as a Result of Orofacial Myofunctional Therapy. Shari Green
Mastication in Orofacial Myofunctional Disorders. Stella M. Cortez Bacha, Cybele F. Mandetta Rispoli
BOOK REVIEWS
President's Perspective. Patricia G. Meyer
Editor's Corner. Patricia M. Taylor
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