Myofunctional Treatment: A Comprehensive Overview

Myofunctional Treatment: A Comprehensive Overview

24 June 2024

Myofunctional treatment, much like orthotropics, seeks to modify the environment surrounding the teeth to enhance dental and facial development. This therapeutic approach emphasizes the influence of muscle function and oral habits on dental alignment and jaw growth, proposing that correcting these functions and habits can lead to improved outcomes. However, several key aspects highlight the controversy and limitations surrounding this treatment.

Similarities with Orthotropics

Both myofunctional treatment and orthotropics share a common goal: to modify the environment around the teeth to promote better dental and facial development. They focus on non-surgical methods to address issues like malocclusion (misalignment of teeth) and improper jaw growth. This involves training and exercises to correct oral posture, breathing, and swallowing patterns.

• Environmental Influence: Like orthotropics, myofunctional therapy emphasizes the importance of altering the functional environment. This includes correcting tongue posture, ensuring proper nasal breathing, and promoting better swallowing techniques.
• Functional Approach: Both approaches operate on the principle that altering muscle function and oral habits can influence dental alignment and facial structure, often targeting young patients whose bones are still developing and more adaptable to change.

Lack of Strong Research Support

One of the major criticisms of myofunctional treatment is the lack of robust scientific evidence supporting its effectiveness. The existing research is often limited to retrospective case reports, which do not provide the same level of evidence as prospective, randomized controlled trials.

• Retrospective Case Reports: Most studies supporting myofunctional therapy are retrospective, examining cases after treatment has been completed. These studies are prone to bias and do not offer strong evidence of causality.
• Need for Rigorous Research: There is a significant need for high-quality, controlled studies to definitively prove the benefits and limitations of myofunctional therapy. Until such evidence is available, the effectiveness of myofunctional therapy remains questionable.

Historical Use of Similar Appliances

The concept of myofunctional therapy is not new. Orthodontists have been using similar functional appliances for many years to address dental and jaw issues.

• Twin-Block, Andresen, and Bionator Appliances: These devices have been employed for decades to correct bite and jaw alignment issues by guiding the growth and positioning of the jaw and teeth. They function by encouraging proper muscle function and oral posture, aligning closely with the principles of myofunctional therapy.
• Functional Orthodontics: Despite the longstanding use of these appliances, prospective randomized trials—the highest level of evidence—have shown that functional appliance treatment has a very small effect on increasing the size and length of the jaws. This highlights that while functional changes can be achieved, the impact on jaw size is minimal.

Genetic Limitations on Jaw Size

A critical point of contention is the claim that myofunctional therapy can change the size of the jaws. Current evidence suggests that the size and shape of the jaws are largely genetically predetermined and cannot be significantly altered through non-surgical means.

• Genetic Predisposition: The growth potential and ultimate size of the jaws are primarily determined by genetic factors. While myofunctional therapy can influence muscle function and oral habits, it is unlikely to significantly change the genetically set parameters of jaw size.
• Skeptical Evidence: No substantial scientific evidence supports the notion that myofunctional therapy can induce significant changes in jaw size. This casts doubt on some of the more ambitious claims made by proponents of the therapy.

Conclusion

Myofunctional treatment offers an intriguing approach to dental and facial development by focusing on modifying the environment around the teeth and influencing muscle function and oral habits. However, it is crucial to recognize its limitations, particularly the lack of strong research evidence and the genetically determined nature of jaw size. While myofunctional therapy shares principles with established orthodontic practices and appliances, its efficacy in producing significant, long-lasting changes remains to be conclusively proven. As with any treatment, it is essential for patients and practitioners to critically evaluate the available evidence and consider all factors before proceeding with myofunctional therapy.