Investigation Of Orofacial Myofunctional Therapy Needs And Multivariate Analysis Of This Therapy Intention In Malocclusion Patients

Objective:This research is aimed at providing a theoretical basis for coordinating clinical orthodontic treatment better,strengthening and stabilizing the effect of correction and carrying out the orofacial myofunctional therapy(OMT)specifically through the clinical examination and questionnaire survey in malocclusion patients to understand the orofacial myofunctional status,to assess OMT needs and to explore the main affecting factors of OMT intention with malocclusion patients.Methods:The 350 patients who were diagnosed with malocclusion and treated in the Department of Oral Orthodontics,the First Hospital of Shanxi Medical University during December 2016 to December 2017,were enrolled in the study.They took the clinical examination by protocol of orofacial myofunctional evaluation with scores(OMES)to assess the OMT needs and were awarded of some OMT related knowledge.The clinical examination mainly include both appearance and movement status of lip,cheek,face,tongue,jaw as well as function of breathing,swallowing,chewing.Some malocclusion patients with orofacial myofunctional disorder conducted a questionnaire survey related therapy intention.The questionnaire involve 17 relevant factors such as general situation,psychological characteristics and personality traits,patient self-cognition,and subjective evaluation of OMT.A full analysis of the data such as Univariate analysis,Chi-squaretest,Correlational analyses and Logistic regression were carried out by using SAS9.2software.Results:1.The results of orofacial myofunctional clinical examination(1)There were 279 patients with orofacial myofunctional disorder,accounting for79.71% of all 350 malocclusion investigators.The total number of OMES was88.61±8.35 points.(2)The differences were statistically significant in the total score of different ages,the score of appearance posture,movement,function,lip,tongue,and cheek(P<0.05).The differences in the lip score between different genders were as the same(P<0.05).(3)Breathing type and abnormal tongue or the vertical position of mandibula were weak positively correlated.Moreover,breathing type had moderate impact on swallowing anomaly and changes of palate.Besides,there was a strong correlation between the way of chewing and facial symmetry while there was a weak correlation between the accuracy of mandibular movement and the symmetry of face.A positive correlation was found among appearance,movement and function.2.The results of questionnaire survey about OMT needs(1)Out of 279 investigators with orofacial myofunctional disorder,248 patients would to receive OMT,accounting for 88.9%.(2)Univariate analysis showed that the relevant influencing factors were gender,marital status,the degree of understanding about OMT,Training time was abundant or not,whether training was persisted to complete,whether training was more time-consuming,whether training was affected normal life,trusted orthodontist or not.The difference was statistically significant(P<0.05).(3)The outcome of Logistic regression was that gender(OR=0.382,95%CI:0.153-0.951),marital status(OR=0.25,95%CI:0.067-0.941),the degree of understanding about OMT(OR=5.665,95%CI:1.343-23.89),whether training waspersisted to complete(OR=4.333,95%CI:1.68-11.173),whether training was more time-consuming(OR=0.251,95%CI:0.099-0.639),whether training were affected normal life(OR=0.242,95%CI: 0.072-0.811).Conclusion:1.The way of applying OMES to evaluate Orofacial myofunctional status can be used as a need screening standard for OMT at large as it is simple,objective and reliable.The age and gender can affect the score of orofacial myofunctional.There is a certain correlation between various parts and positions of Orofacial myofunctional status.2.Malocclusion patients have a higher objective need for OMT.It is suggest that orthodontists should attach importance to propagate OMT actively and to improve the patient's attention about OMT widely.3.The intention of OMT is affected by a variety of factors,including gender,marital status,understanding of the therapy,whether the training is more time-consuming,affects normal life and can they stick to it.4.Malocclusion patients have a stronger subjective willingness to accept OMT which point out that orthodontists ought to develop the scientific depth of the patient's cognition about the therapeutic theory and provide the more quality and individualized treatment plans.Consequently more patients can benefit from this treatment.