title: Myofunctional and speech rehabilitation after orthodontic-surgical treatment of dento-maxillofacial dysgnathia.
abstract: OBJECTIVE
  The lingual dysfunctions play a considerable role in the pathogenesis of dentoskeletal dysmorphisms. The treatment of dento-maxillofacial dysgnathia implies a functional rehabilitation to re-harmonize the stomatognathic system. This study aims to demonstrate the importance of a rehabilitation protocol of functional orofacial parameters at the end of a surgical-orthodontic treatment in order to achieve long-term success.
  
  
  METHODS
  After orthognathic surgery, facial expression exercises and jaw exercises are prescribed to promote the recovery of neuromuscular function. At the end of treatment, a sample of 30 dysgnathic patients underwent a functional evaluation of the orofacial district to identify any lingual or articulatory dysfunctions. The information gathered led to an individual re-education program that consisted of an active myofunctional-logopedic approach integrated with appliances used as retention.
  
  
  RESULTS
  19 patients needed myofunctional therapy to re-educate deglutition and tongue posture. Articulatory disorders were found in 7 patients originally suffering from Class III and/or open-bite skeletal disharmony; 5 of these completed rehabilitation with speech therapy. After rehabilitation the functional parameters were completely normalized in 12 patients; in 5 cases, partial improvements were obtained, while in 2 cases the therapy was ineffective.
  
  
  CONCLUSIONS
  In a patient undergoing post-surgical reconsolidation of his/her functional equilibrium even an uncontrolled speech defect may lead to an instable result. Only through an interdisciplinary approach it is possible to intercept and re-educate all the functions that are not compliant with the structural changes and to eliminate a tendency to relapse of the dysgnathia.
authors.affiliation: Department of Sense Organs, Sapienza University of Rome.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Gallerano
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ruoppolo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Silvestri
mesh_terms: D000293:Adolescent; D000328:Adult; D001184:Articulation Disorders / Q000534:rehabilitation; D003680:Deglutition Disorders / Q000534:rehabilitation; D005081:Exercise Therapy / Q000295:instrumentation / Q000379:methods; D005152:Facial Muscles / Q000294:innervation / Q000502:physiology; D005260:Female; D006801:Humans; D008046:Lip / Q000502:physiology; D008297:Male; D008310:Malocclusion / Q000534:rehabilitation* / Q000601:surgery; D008312:Malocclusion, Angle Class II / Q000534:rehabilitation / Q000601:surgery; D008313:Malocclusion, Angle Class III / Q000534:rehabilitation / Q000601:surgery; D052580:Muscle Stretching Exercises / Q000379:methods; D020247:Myofunctional Therapy / Q000295:instrumentation / Q000379:methods*; D009469:Neuromuscular Junction / Q000502:physiology; D024343:Open Bite / Q000534:rehabilitation / Q000601:surgery; D016382:Orthodontic Appliance Design; D009971:Orthodontics, Corrective / Q000379:methods*; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D010348:Patient Care Team; D016059:Range of Motion, Articular / Q000502:physiology; D013070:Speech Therapy / Q000379:methods*; D014059:Tongue / Q000502:physiology; D014061:Tongue Habits / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult