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      Orofacial muscles activity in children with swallowing dysfunction and removable functional appliances

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          Abstract

          Swallowing dysfunction is a frequent disorder among children and refers to an altered tongue posture and abnormal tongue movement during swallowing. Removable functional appliance is one of the treatments applied by dentistry to correct this disorder. The aim of this study was to evaluate any differences on orofacial muscles activity in children with swallowing dysfunction with and without removable functional appliances. 68 children were eligible for the study and divided into the orthodontic group (OG) and the no-orthodontic group (NO-OG). Both groups performed a dental occlusion-class evaluation, a swallowing function test and a myoscan analysis in order to measure perioral forces (i.e. tongue extension force, lip pressure, masseter contraction force). Our results showed a significant difference (P=0.02) between OG and NO-OG for the tongue extension force, whereas no significant differences (P>0.05) were found for the other parameters. Our findings suggest that children with swallowing dysfunction and removable functional appliance show orofacial muscles activity within the range of reference values (except for the lip pressure). However, we hypothesize that orthodontic treatment can achieve more effective results with integration of myofunctional therapy.

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          Most cited references34

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          The Relationship Between the Stomatognathic System and Body Posture

          In recent years, many researchers have investigated the various factors that can influence body posture: mood states, anxiety, head and neck positions, oral functions (respiration, swallowing), oculomotor and visual systems, and the inner ear. Recent studies indicate a role for trigeminal afferents on body posture, but this has not yet been demonstrated conclusively. The present study aims to review the papers that have shown a relationship between the stomatognathic system and body posture. These studies suggest that tension in the stomatognathic system can contribute to impaired neural control of posture. Numerous anatomical connections between the stomatognathic system’s proprioceptive inputs and nervous structures are implicated in posture (cerebellum, vestibular and oculomotor nuclei, superior colliculus). If the proprioceptive information of the stomatognathic system is inaccurate, then head control and body position may be affected. In addition, the present review discusses the role the myofascial system plays in posture. If confirmed by further research, these considerations can improve our understanding and treatment of muscular-skeletal disorders that are associated with temporomandibular joint disorders, occlusal changes, and tooth loss.
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            Masticatory muscle influence on craniofacial growth.

            The influence of the masticatory muscle function on craniofacial growth has been recorded in a series of animal experimental and clinical studies. The common characteristic of these investigations is that the elevator muscles of the mandible influence the transversal and the vertical dimensions of the face. The increased loading of the jaws due to masticatory muscle hyperfunction may lead to increased sutural growth and bone apposition, resulting in turn in an increased transversal growth of the maxilla and broader bone bases for the dental arches. Furthermore, an increase in the function of the masticatory muscles is associated with anterior growth rotation pattern of the mandible and with well-developed angular, coronoid, and condylar processes.
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              Dental occlusion and postural control in adults.

              We studied the influence of a dental occlusion perturbation on postural control. The tests were performed in three dental occlusion conditions: (Rest Position: no dental contact, Maximal Intercuspal Occlusion: maximal dental contact, and Thwarted Laterality Occlusion: simulation of a dental malocclusion) and four postural conditions: static (stable platform) and dynamic (unstable platform), with eyes open and eyes closed. A decay of postural control was noted between the Rest Position and Thwarted Laterality Occlusion conditions with regard to average speed and power indexes in dynamic conditions and with eyes closed. However, the head position and stabilization were not different from those in the other experimental conditions, which means that the same functional goal was reached with an increase in the total energetic cost. This work shows that dental occlusion differently affects postural control, depending on the static or dynamic conditions. Indeed, dental occlusion impaired postural control only in dynamic postural conditions and in absence of visual cues. The sensory information linked to the dental occlusion comes into effect only during difficult postural tasks and its importance grows as the other sensory cues become scarce.
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                Author and article information

                Contributors
                Journal
                Eur J Transl Myol
                EJTM
                European Journal of Translational Myology
                PAGEPress Publications, Pavia, Italy
                2037-7452
                2037-7460
                27 August 2019
                02 August 2019
                : 29
                : 3
                : 8267
                Affiliations
                [1 ]Department of Psychology, Educational Science and Human Movement, University of Palermo , Palermo, Italy
                [2 ]Posturalab Italia Research Institute , Palermo, Italy
                [3 ]PhD Program in Health Promotion and Cognitive Sciences, University of Palermo , Palermo, Italy
                [4 ]Istituto Euromediterraneo di Scienza e Tecnologia – IEMEST , Palermo, Italy
                [5 ]Bio.Ne.C. Department, Audiology Section, University of Palermo , Palermo, Italy
                [6 ]Di.Chir.On.S. Department, Physical Medicine and Rehabilitation, University of Palermo , Palermo, Italy
                [7 ]Department of Biomedical Sciences, Division of Human Anatomy, University of Sassari , Sassari, Italy
                [8 ]Faculty of Medicine and Dental Surgery, Sapienza University of Rome , Rome, Italy
                Author notes
                Via Giovanni Pascoli, 6, Palermo, Italia. +39 091 23896910 +39 091 23860894 valerio.giustino@ 123456unipa.it

                Authors contributions

                All authors have participated in the conception and study design, data acquisition, analysis and interpretation, drafting of the manuscript and revised critically it. All authors have read and approved the final version of the manuscript and agree with the order of presentation of the authors.

                Conflict of Interest

                The authors declare no conflicts of interest.

                Article
                10.4081/ejtm.2019.8267
                6767995
                31579473
                276f3fde-9b7c-4c82-874c-aae69d091d2a
                Copyright @

                This article is distributed under the terms of the Creative Commons Attribution Noncommercial License ( by-nc 4.0) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

                History
                : 07 May 2019
                : 05 June 2019
                Page count
                Figures: 1, Tables: 2, Equations: 0, References: 34, Pages: 5
                Funding
                Funding None.
                Categories
                Original Article

                orofacial muscles,perioral muscles,muscles activity,swallowing dysfunction

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