Infantile Swallowing and Tongue Malposition Necessitating Tongue Rehabilitation, Patients With Anterior Open Bite Malocclusion and Who Benefited of an Orthognathic Surgery
Conditions
Keywords
Anterior open bite, Orthognathic surgery, Tongue rehabilitation
Brief summary
The anterior gap is defined by a lack of contact between the upper and lower dental arches. It is mainly due to the persistence of infantile swallowing during and after childhood, i.e. interposition of the tongue between the two dental arches. Patients presenting with an anterior gap in adulthood are likely to develop functional sequelae (masticatory difficulties, dental loosening, periodontal disease, etc.) and aesthetic sequelae (edentulous smile, excess height of the lower third of the face compared to the upper and middle third). Patients who are diagnosed with this condition very often benefit from orthodontic-surgical treatment, comprising a period of orthodontics followed by orthognathic surgery to close the anterior gap. This is combined with lingual re-education to treat infantile swallowing. This lingual re-education is not always carried out, either because infantile swallowing has not been diagnosed, or because of a lack of cooperation on the part of the patient, or because of difficulties in finding a suitable specialist. When rehabilitation is introduced, it is sometimes only after surgery, and for a short time. For example, it has been observed that among all patients undergoing orthognathic surgery, those with an anterior gap were particularly at risk of surgical treatment failure, or recurrence in the short to medium term. The main reason cited was the persistence of infantile swallowing and consequent malpositioning of the tongue between the dental arches, creating permanent pressure on the lingual surface of the teeth and eventually leading to recurrence of the gap. Identifying patient management factors associated with postoperative recurrence of anterior hollowness in patients with infantile swallowing would enable us to adapt the management of these patients.
Interventions
OTHERtype of post-operative rehabilitation : with physiotherapy or speech therapy
mean duration of rehabilitation * assess the tongue position at rest, and during speech * assess the surgical movements associated with relapse : advancement, rotation, expansion, genioplasty
Sponsors
Hospices Civils de Lyon
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Major patients * Having undergone ortho gnathic surgery in the Maxillofacial Surgery Department of the Croix Rousse Hospital * Patients with an anterior gap of more than 3 mm * Abnormal tongue position at diagnosis
Exclusion criteria
* Syndromic patients (cleft lip and palate, craniostenosis) * Patient refusal
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Measurement of the association between anterior open bite recurrence, defined as the absence of contact between the upper and lower incisors at 6 months postoperatively, and the rehabilitation factors. | 6 months | Duration of rehabilitation in months |
Countries
France
Outcome results
None listed