Orofacial myofunctional therapy assisted by a prefabricated functional appliance: Toward a necessary paradigm shift

Introduction:

Orofacial myofunctional therapy (OMT) involves the re-education of the muscles, functions, and resting postures of the orofacial complex. It is used in the therapeutic management of orofacial dysfunction in patients of all ages and with a wide range of disorders and comorbidities. Objective: The main objective of this article was to advocate the combination of OMT with the use of prefabricated functional appliances (PFAs) in orthodontics. Materials and method: A summary of published data was carried out and the conclusions of a cross-sectional epidemiological study were reported. The aim of the study was to assess the current state of OMT in orthodontics in France. Consideration was given to the relevance of the arguments put forward by manufacturers regarding the specific features of their devices and their supposed effects. Results: Published data, albeit of varying methodological quality, seem to show the superiority of OMT combined with the use of a PFA, compared with the use of OMT without a PFA. A new, more effective, simpler, and less time-consuming approach to PFA-assisted OMT is proposed. The project for a new PFA model is presented. Ten clinical cases are presented to illustrate the clinical and administrative aspects of PFA-assisted OMT. Original clinical approaches are also presented: mandibular disocclusion and re-centering wedges (MDRWs), anti-retrusion wedges (ARWs), and sequential multi-attachment bonding (SMB), applied first to the mandibular arch then the maxillary arch. Conclusion: PFA-assisted OMT appears to be a necessary paradigm shift, which it would be useful to offer to our patients.