Title	Myofunctional Orthodontics May or May Not Produce a More Stable Result Than Traditional Orthodontics
Clinical Question	In patients requiring orthodontic treatment, does myofunctional orthodontics produce a more stable result than traditional orthodontics?
Clinical Bottom Line	There is insufficient evidence in the literature to support the claim that myofunctional orthodontics provides a more stable result than traditional orthodontics.
Best Evidence
PubMed ID Author / Year Patient Group Study type (level of evidence) 21212169 Tancan/2012 22 patients with Class II Division 1 Malocclusion. Case Series Key results Masticatory muscle activity is decreased after treatment with pre-orthodontic trainer when measured by electromyography (EMG). The evidence provided demonstrates a myofunctional appliance has the following effects when measured by EMG: decreased activity of the Anterior Temporalis muscle while sucking (P<.05) and clenching (P<.001); decreased activity of the Mentalis muscle while clenching (P<.001); decreased acivity of the Orbicularis Oris muscle while sucking (P<.05) and clenching (P<.001); decreased activity of the Masseter muscle while clenching (P<.01). 22565519 Pachori/2012 3 growing patients with Class II Division 1 Malocclusion. Case Series Key results Mandibular retrognathism can be corrected with myofunctional appliances.
Evidence Search	("Myofunctional Therapy"[Mesh] AND "Orthodontics"[Mesh]); ("Myofunctional Therapy"[Mesh] AND "Orthodontics"[Mesh]) AND "Orthodontic Retainers"[Mesh])
Comments on The Evidence	The relevant articles employed were case studies with few subjects (15 patients; 3 patients) which required orthodontic treatment. No randomization was used. The results of the studies did not adequately relate how the myofunctional appliance produces a more stable result after treatment. Neither study had sufficient follow up to support the claim that retainers would not be required for these patients to maintain results long term. As the success of treatment of the Tancan study was an assessment of esthetics, the study reflects easily biased, subjective findings. The Pachori study provides objective data produced by electromyography, but there is insufficient evidence to support the claim that decreased masticatory muscle function improves occlusion.
Applicability	Insufficient evidence exists to determine applicability.
Specialty	(Orthodontics)
Keywords	myofunctional; orthodontics; myofunctional orthodontics
ID#	2667
Date of submission	03/26/2014
E-mail	CaesarR@livemail.uthscsa.edu
Author	Ray Caesar
Co-author(s)
Co-author(s) e-mail
Faculty mentor	Clarence C. Bryk, DDS, MS
Faculty mentor e-mail	BrykC@uthscsa.edu
Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) None available