Key Takeaway
Early orthodontic and orofacial muscle training shows promise for correcting myofunctional problems in developing dentition, but existing evidence quality is questionable.
Summary
This systematic review and meta-analysis evaluated evidence on early orthodontic intervention combined with orofacial muscle training for correcting myofunctional and myoskeletal problems in children with developing dentition.
From 265 initial search results across MEDLINE, Cochrane, and LILACS databases, 15 studies qualified - 8 RCTs and 7 controlled clinical trials. These measured skeletal and dentoalveolar changes via cephalometric analysis, mouth posture, lip closure, tongue resting position, tongue pressure, and swallowing patterns.
Quantitative synthesis was only possible for 2 of the included RCTs. No evidence supported bonded lingual spurs over banded fixed appliances for anterior open bite correction (SMD: -0.03; 95% CI: -0.81 to 0.74; P = 0.94). While early orthodontic and myofunctional treatment appears promising, the quality of existing evidence was deemed questionable.
Methods
Systematic review and meta-analysis searching MEDLINE, Cochrane, and LILACS databases without language restrictions. Included RCTs and controlled clinical trials comparing interventions for anterior open bite correction, breathing patterns, swallowing, and tongue positioning in children with developing dentition.
Key Results
- 15 studies included (8 RCTs, 7 controlled clinical trials)
- Quantitative synthesis possible for only 2 RCTs
- No difference between bonded lingual spurs vs banded fixed appliances for open bite (SMD: -0.03; 95% CI: -0.81 to 0.74; P = 0.94)
- Improvements noted in mouth posture, tongue position, and swallowing patterns across individual studies
Limitations
- Quality of existing evidence described as "questionable"
- Only 2 studies amenable to quantitative meta-analysis
- High heterogeneity in interventions and outcomes
- Mix of RCTs and non-randomized controlled trials
- Limited long-term follow-up data