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KMID : 1144020170130010019
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Journal of Korean Association for Disability and Oral Health
2017 Volume.13 No. 1 p.19 ~ p.22
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TREATMENT OF OPENBITE WITH MYOFUNCTIONAL THERAPY IN MOYAMOYA DISEASE PATIENT
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Lee Chang-Keun
Kim Jae-Gon
Lee Daw-Woo
Yang Yeon-Mi
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Abstract
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Moyamoya disease is characterized by progressive bilateral narrowing of the internal carotid arteries(ICA) and their main branches, and formation of a fine vascular network (moyamoya vessels) at the base of brain. Mild intellectual or motor impairment, or both can be seen in moyamoya disease patient. Patients having intellectual disability usually have malocclusions associated with oral habits such as tongue thrusting, bruxism, or clenching.
A patient with moyamoya disease and cerebral palsy visited Chonbuk National University hospital for dental examination. She showed mild openbite on anterior teeth, and had oral habits such as mouth breathing, tongue thrusting, and drooling. She was treated with myofunctional therapy(MFT) whose purpose was to strengthen orofacial muscles. Lip closing force and bite force were recorded to evaluate the muscle tone. Tongue crib was delivered to restrict tongue thrusting habit, since her compliance to the MFT was decreased after 6 months of treatment. With the MFT and tongue crib, the openbite was fairly improved.
When myofunctional therapy has difficulty in obtaining good compliances, the treatment should not be effective enough. Although intellectually disabled patients are not compliant enough, thus a habit breaking device should be needed to treat the openbite caused by oral habits, dentist should make an effort to do MFT, since it could reduce a treatment period, and enhance the stability.
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KEYWORD
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Moyamoya disease, Openbite, Myofunctional therapy, Tongue crib
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