Ortodontide Miyofonksiyonel Tedavi Yaklaşımları
Özet
Ortodontide maloklüzyonların etiyolojisinde genetik ve dentoalveoler faktörlerin yanı sıra parmak emme, ağız solunumu ve infantil yutkunma gibi kötü ağız alışkanlıkları ile yumuşak doku fonksiyon bozuklukları önemli bir rol oynamaktadır. Bu tür anomalilerin tedavisinde ortodontik yaklaşımlara ek olarak, çiğneme ve yüz kaslarını dengeleyerek stabil sonuçlar elde etmeyi amaçlayan miyofonksiyonel tedaviler uygulanmaktadır. Tarihsel süreçte Kingsley, Robin, Andersen ve Herbst gibi isimlerle başlayan fonksiyonel çene ortopedisi, günümüzde gelişmiş elastomerik yapılı Eruption Guide Appliance (EGA), Preortodontik Trainer (T4K) ve Myobrace gibi prefabrike apareylerle çeşitlenmiştir. Miyofonksiyonel tedaviler, özellikle kasların anormal fonksiyonlarını erken dönemde normalize ederek dental arkların ve yüz estetiğinin gelişimine katkı sağlar. Tedavi sürecinde dil, dudak ve yanak kaslarını güçlendirmeye yönelik çeşitli egzersizler ve alışkanlık kırıcı aygıtlar aktif olarak kullanılır. Erken teşhis ve doğru hasta seçimiyle uygulanan bu yöntemler, fonksiyonel matrisi düzenleyerek ileride ihtiyaç duyulabilecek maliyetli ortodontik tedavi gereksinimini azaltmaktadır.
In the etiology of malocclusions in orthodontics, genetic and dentoalveolar factors, as well as bad oral habits such as thumb sucking, mouth breathing, and infantile swallowing, along with soft tissue dysfunctions, play a significant role. In the treatment of such anomalies, in addition to orthodontic approaches, myofunctional treatments are applied to achieve stable results by balancing masticatory and facial muscles. Functional jaw orthopedics, which historically began with names like Kingsley, Robin, Andersen, and Herbst, has evolved today with prefabricated appliances featuring advanced elastomeric structures such as the Eruption Guidance Appliance (EGA), Preorthodontic Trainer (T4K), and Myobrace. Myofunctional treatments contribute to the development of dental arches and facial aesthetics, especially by normalizing the abnormal functions of muscles at an early stage. Various exercises aimed at strengthening the tongue, lip, and cheek muscles, along with habit-breaking devices, are actively used during the treatment process. These methods, applied with early diagnosis and correct patient selection, organize the functional matrix and reduce the need for costly orthodontic treatments that may be required in the future.
Referanslar
Ülgen M. Ortodonti Anomaliler, Sefalometri, Etioloji, Büyüme ve Gelişim, Tanı: Bölüm 3:Dişsel Anomaliler. Yeditepe Üniversitesi Yayınları, İstanbul; 2000:23-41.
Perkün F. Çene Ortopedisi İ.Ü. Diş Hekimliği Fakültesi Yayın No:17 İstanbul; 1973 CiltI-III.
Moss, M.L.,Salentijn, L. The primary role of functional matrices in facial growth. Am J Orthod, 1969;55(6):566-77.
Kumar V, Shivanna V, Kopuri RC. Knowledge and attitude of pediatricians toward digit sucking habit in children. J Indian Soc Pedod Prev Dent 2019;37(1):18. doi: 10.4103/JISPPD.136-18.
Dos Santos RR, Nayme JG, Garbin AJ, et al. Prevalence of malocclusion and related oral habits in 5-to 6-year-old children. Oral Health Prev Dent 2012; 10(4): 311- 318. doi: 10.3290/j.ohpd.a28901.
Anderson GM. Practical Orthodontics. 7th ed. CV Mosby Co. St Louis, 1948.
Straub W. Malfunction of the tongue, Part 1. The abnormal swallowing habit; its cause, effects and results in relation to orthodontic treatment and speech therapy. Am J Orthod 1960;46:404-424.
Graber TM, Rakosi T, Petrovic AG. Dentofacial Orthopedics with Functional Appliances, St. Louise, Toronto, Princeton, The CV Mosby Company, 1997:108-378.
Nielsen L. Vertical malocclusions: Etiology, development, diagnosis and some aspects of treatment. The Angle Orthodontist 1991;61:247-260.
Saccomanno S, Antonini G, D’Alatri L, et al. Causal relationship between malocclusion and oral muscles dysfunction: a model of approach. Eur J Paediatr Dent. 2012;13:321-3.
McNamara, J.A., Jr., Peterson, J.E., Jr.,Alexander, R.G. Three-dimensional diagnosis and management of Class II malocclusion in the mixed dentition. Semin Orthod 1996;2 (2):114-37.
Graber T.M.: Orthodontics: current principles and techniques. The C.V. Mosby Co., StLouis, Toronto, Princeton, 2005.
Sarı Z., Uysal T., Karaman A.İ., Başçiftçi F.A., Üşümez S., Demir A.: Ortodontik maloklüzyonlar ve tedavi seçeneklerinin değerlendirilmesi: epidemiyolojik çalışma Türk Ortodonti Dergisi 2003;16:119-26.
Ellis E, McNamara JA. Components of adult Class III open-bite malocclusion. Am J Orthod 1984;86:277-90.
Fujiki T, Inoue M, Miyawaki S, et al. Relationship between maxillofacial morphology and deglutitive tongue movement in patients with anterior open bite. Am J Orthod Dentofacial Orthop 2004;125:160e7.
Popovich F, Thompson GW. Thumb-and finger-sucking: its relation to malocclusion. Am J Orthod 1973;63:148-55.
Miyawaki S, Oya S, Noguchi H, et al. Long-term changes in dentoskeletal pattern in a case with Beckwith- Wiedemann syndrome following tongue reduction and orthodontic treatment. Angle Orthod 2000;70:326-31.
Straub WJ. Malfunction of the tongue: Part II. The abnormal swallowing habit: its causes, effects, and results in relation to orthodontic treatment and speech therapy. Am J Orthod 1961; 47:596-617.
Popovich F, Thompson GW. Thumb-and finger-sucking: its relation to malocclusion. Am J Orthod 1973;63:148-55.
Lin L-H, Huang G-W, Chen C-S. Etiology and treatment modalities of anterior open bite malocclusion. J Exp Clin Med 2013;5:1-4
Barbre RE, Sinclair PM. A cephalometric evaluation of anterior open bite correction with the magnetic active vertical corrector. Angle Orthod 1991;61:93-102.
Bondemark L, Holm A-K, Hansen K, et al. Long-term stability of orthodontic treat- ment and patient satisfaction: a systematic review. Angle Orthod 2007;77:181-91.
Epker BN, Fish LC. Surgical-orthodontic correction of open- bite deformity. Am J Orthod 1977;71:278-99.
Lopez-Gavito G, Wallen TR, Little RM et al. Anterior open-bite malocclusion: a longitudinal 10-year postretention evaluation of orthodontically treated patients. Am J Orthod 1985;87:175-86.
Miller H. The early treatment of anterior open bite. Int J Orthod 1969;7:5.
Cayley A, Tindall A, Sampson W, et al. Electropalatographic and cephalometric assessment of myofunctional therapy in open-bite subjects. Aust Orthod J 2000;16:23-33.
Takahashi O, Iwasawa T, Takahashi M. Integrating orthodontics and oral myofunctional therapy for patients with oral myofunctional disorders. Int J Orofac Myol Off Pub Int Assoc Orofac Myol 1995;21:66-72.
Subtelny JD, Sakuda M. Open-bite: diagnosis and treatment. Am J Orthod 1964;50:337-58.
Paul JL, Nanda RS. Effect of mouth breathing on dental occlusion. Angle Orthod 1973;43(2):201-206.
Hulcrantz E, Larson M, Hellquist R, et al. The influence of tonsillar obstruction and tonsillectomy on facial growth and dental arch morphology. Int J Pediatr Otorhinolaryngol 1991;22:125-34.
5.Freeland, T.D. Muscle function during treatment with the functional regulator. Angle Orthod, 1979;49(4):247-258.
Pancherz, H. (1997). The Modern Herbst Appliance. L. L.Duncan (Ed.). Dentofacial Orthopedics with Functional Appliances (s. 336-366). St.Louis,Missouri: Mosby-Year Book
1.Balters, W. Ergebnis der gesteuerten selbstheilung von kieferothopadischen anomalien. Dutsch Zahnaerztl 1960;15:241.
Frankel, R. The theoretical concept underlying the treatment with functional correctors. Trans.Eur.Orthod.Soc., 1966;42:233-54.
Clark, W.J. The twin block technique. A functional orthopedic appliance system. Am J Orthod Dentofacial Orthop, 1988;93(1):1-18.
Myrlund R, Dubland M, Keski-Nisula K, et al. One year treatment effects of the eruption guidance appliance in 7- to 8-year-old children: a randomized clinical trial. Eur J Orthod 2015;37:128-34.
Bergersen EO. The eruption guidance myofunctional appliance: How it works, how to use it. Func Orthod 1984;1:28-35.
Ramirez-Yanez, G. (2005-2007).(29.08.2022 tarihinde http://www.myoresearch.com dan ulaşılmıştır)
Bauss O., Rohling J., Schwetstka-Poly R. Prevalance of traumatic injuries to the permanent incisors in candidates for orthodontic treatment. Dent Traumatol. 2004;20(2):61-66.
.Frankel, R. The treatment of Class II, Division 1 malocclusion with functional correctors. Am J Orthod 1969;55(3):265-75.
Graber, T.M. (2005). Functional Appliances. P. Rudolph (Ed.). Orthodontics:Current Principles and Techniques (Fourth Edition bs.,s. 493-542). St.Louis,Missouri: Mosby
Flutter J. The negative effect of mouth breathing on the body and development of the child. (29.08.2022 tarihinde http://www.fasttraxortho.com/Mouthbreathing adresinden ulaşılmıştır)
Bigenzahn W, Fischman L, Mayrhofer-Krammel U. Myofunctional Therapy in Patients with Orofacial Dysfunctions Affecting Speech. Folia Phoniatr 1992;44:238-44.
. Ülgen M.: Ortodonti: Anomaliler, sefalometri , etyoloji, büyüme , gelişim, tanı. Yeditepe Üniversitesi Yayınları, İstanbul, 2000.
American Academy of Pediatric Dentistry Guideline on Management of the developing occlusion in Pediatric Dentistry. Revised in 2009.
Quadrelli C, Gheorgiu M, Marchetti C, Ghiglione V. Early myofunctional approach to skeletal Class II. Mondo Orthod 2002;2:109-22.
Owman-Moll P, Ingervall B. Effect of oral screen treatment on dentition, lip morphology, and function in children with incompetent lips. Am J Orthod 1984;85:37-76.
Davidovitch M, Mclnnis D, Lindauer SJ. The effects of lip bumper therapy in the mixed dentition. Am J Orthod Dentofacial Orthop 1997;111:52-8.
Janson GRP et al. Class II treatment effects of the Frankel appliance. European Journal of Orthodontics 2003;25:301-9.
Bergersen, EO. The eruption guidance myofunctional appliance: Case selection, timing, motivation, indications and controindications in its use. Funct Orthod. 1985, Vol. 2, pp. 17-33.
Bergersen EO, Manzini P. L' utilizzo del Nite-guide e Occlus-o-guide in ortodonzia preventiva e intercettiva. s.l.: Utet, 2003.
Bergersen EO. The eruption guidance myofunctional appliance: case selection, timing, motivation, indicates and contraindicates in its use. Func Orthod 1985;2(1):17-21,24-25,28-35.
Bishara, S.E.,Ziaja, R.R. (1989) Functional appliances: a review. Am J Orthod Dentofacial Orthop 1989;95(3):250-8.
Kalogirou, K., Ahlgren, J.,Klinge, B. Effects of buccal shields on the maxillary dentoalveolar structures and the midpalatal suture--histologic and biometric studies in rabbits. Am J Orthod Dentofacial Orthop, 1996;109(5):521-30.
Creekmore, T.D.,Radney, L.J. Frankel appliance therapy: orthopedic or orthodontic? Am J Orthod, 1983;83(2):89-108.
Graber T.M. (1997). The Frankel Function Regulator. L. L.Duncan (Ed.). Dentofacial Orthopedics with Functional Appliances (s. 223-267). St.Louis,Missouri: Mosby
Bergersen EO. The eruption guidance myofunctional appliance: How it works, how to use it. Func Orthod 1984;1:28-35.
Myrlund R, Dubland M, Keski-Nisula K,et al. One year treatment effects of the eruption guidance appliance in 7- to 8-year-old children: a randomized clinical trial. Eur J Orthod 2015;37:128-34.
. S.Fıratlı ve ark. Angle Sınıf III olguların tedavisinde Frankelin fonksiyon düzenleyicisi İ.Ü Dişhekimliği Dergisi Cilt 24 Sayı 3 1990.
Myofunctional Research Co. (29.08.2022 tarihinde www.myoresearch .com. adresinden ulaşılmıştır)
Dinkova M. Vertical Control of Overbite in Mixed Dentition by Trainer System. Journal of IMAB 2014;20:648-54.
Linder-Aronson S. Respiratory function in relation to facial morphology and the dentition. Br J Orthod 1979;6:59-71
Ülker AE, Maşeroğlu Ö, Tulunoğlu Ö. Çocuk Dişhekimliğinde Kullanılan Alışkanlık Kırıcı Apareyler; Quad Helix, Position Trainer, Palatal Crib. Hacettepe Dişhekimliği Fakültesi Dergisi 2007;31:28-33.
Uysal T, Yagci A, Kara S, Okkesim S. Influence of Pre-Orthodontic Trainer treatment on the perioral and masticatory muscles in patients with Class II division 1 malocclusion. Eur J Orthod 2012;34:96-101.
Ramirez-Yanez GO, Paulo F. Early Treatment of a Class II, Division 2 Malocclusion with the Trainer for Kids (T4K): A Case Report. J Clin Pediatr Dent 2008;32:325-30.
Üşümez S, Uysal T, Sarı Z, et al. The Effects of Early Preorthodontic Trainer Treatment on Class II, Division I Patient. Angle Orthod 2004;74:605-9.
Farrell C (2003) T4A the trainer for alignment. Myofunctional res Co (29.08.2022 tarihinde www.myosearch.com adresinden ulaşılmıştır)
Bresolin D, Shapiro PA, Shapiro GG, et al. Mouth breathing in allergic children: its relationship to dentofacial development. Am J Orthod 1983;83(4):334-40.
. Nevant CT, Buschang PH, Alexander RG, et al. Lip bumper therapy for gaining arch length. Am J Orthod Dentofacial Orthop 1991;100(4):330-6.
Enacar A, Keçik D. Açık kapanışın myofonksiyonel tedavisinde preorthodontic trainer uygulaması: olgu sunumu. Türk Ortodonti Dergisi 2009;22:248-55.
Üşümez ve ark. The effects of early preorthodontic trainer treatment on Class II, division 1 patient. Angle Orthod 2004;74:605-9.
Usha Mohan Das, Reddy D. JISPD 2010;28(1).
Ülker AE. Hacettepe Üniversitesi Diş hekimliği Fakültesi Dergisi 2007;31(3):28-33.
Aleksic E, Milic J, Gajic M. Trainer system appliances in early treatment of malocclusions. J Clin Pediatr Dent 2008;32(4): 325-30.
Uysal T et al. The European Journal of Orthodontics · January 2011 DOI: 10.1093/ejo/cjq169 ·
Pallavi Pujar https://doi.org/10.1155/2013/717435
Marianna Pellegrino https://doi.org/10.1155/2020/8899184
Iwata T. Effects of a Prefabricated Functional Appliance in the Early Mixed Dentition Period. Pediatr Dent Care 2016;1:104. doi: 10.4172/2573- 444X.1000104.
Miroslova D. Vertıcal Control of Overbıte ın Mıxed Dentıtıon by Traıner System. J of IMAB. 2014;20(5).
Kee-Sang Hong et al. Iran J Public Health, 2016;45(10):1373-5.
Idris G European Journal of Orthodontics, 2019;41(1):21-8.
Sergio Andres Camargo Rojas ve ark. Revista Mexicana de Ortodoncia 2018;6(1):43-9.
. Dt. Merve Karaışık Soysal tez ( 29.08.2022 tarihinde http://hdl.handle.net/11655/22646 adresinden ulaşılmıştır)
Tripathi NB, Patil SN. Treatment of Class II Division 1 Malocclusion with Myofunctional Trainer System in Early Mixed Dentition Period. JCDP 2011;12(6):497-500.
