Wednesday, 3 August 2011

Anterior open bite and tongue positions, DPJO

A very interesting article can be found at the current issue of the Brazilian journal. The anterior open bite patients are among the hardest ones to treat, and the most common complication is the relapse of the treatment result even after complete closure of the open bite.

By looking a little more into the reason that created the malocclusion we can try to enhance our treatment results. The equilibrium theory is know from Proffit, and from studies of researchers like Thüer in the 80ies. It is according to those beliefs that the equilibrium between the tongue function and position, and the lips assures a perfect inter-incisal angle and stability at the front region.

Take a look at this scheme of different tongue positions, taken from the article:

The first one is the normal position of the tongue, showing the forces exerted upon swallowing.

This is how it may look when a high tongue position is established.

This is how it may look when a horizontal tongue position is established.

Now why is it important to differentiate between those positions? 
-Well, obviously because there are different approaches to treat depending on where the tongue position is and how we are going to try and change it.

There is one small point to be made regarding the change of tongue position. That is that it is extremely difficult to alter the tongue function permanently (for some researchers this is not possible). Very impressive results have been shown by many clinicians (first and foremost it was Dr. Frankel) but unfortunately the treatments needed are long, and quite often those patients relapse again to an open bite.

That been said, please have a look at the link of the article at the Brazilian journal, it is definitely worth the read:

Link to the pdf of the article.

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