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Informationen aus Orthodontie & Kieferorthopädie 2016; 48(01): 29-34
DOI: 10.1055/s-0042-103451
Übersichtsartikel
© Georg Thieme Verlag KG Stuttgart · New York

Äquilibrium von Zunge, Lippen und Wangen

Equilibrium between Tongue, Lips and Cheeks
B. Lanzer
1   Fachbereich Kieferorthopädie, Bernhard-Gottlieb-Universitätszahnklinik Wien, Österreich
,
H.-P. Bantleon
1   Fachbereich Kieferorthopädie, Bernhard-Gottlieb-Universitätszahnklinik Wien, Österreich
› Author Affiliations
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Publication History

Publication Date:
14 April 2016 (online)

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Zusammenfassung

Die vorliegende Literaturübersicht befasst sich mit dem Zusammenspiel von Zunge, Lippen und Wangen und ihrem Einfluss auf die Zahnstellung. Dazu wird der aktuelle Wissensstand über die neutrale Zone, Schluckmuster, Habits, die Ätiologie von Malokklusionen, der Kreuzbiss, die Atmung, der Druck von Zunge, Lippen und Wangen und die myofunktionelle Therapie erörtert.

In der neutralen Zone befinden sich die Zähne in einer Lage zwischen den horizontal gerichteten Kräften von Zunge, Lippen und Wangen – die Zähne nehmen eine stabile Position ein. Beeinflusst wird die neutrale Zone von verschiedensten Parametern wie bspw. einem falschen Schluckmuster oder diversen Habits wie Schnuller- oder Daumenlutschen. Das viszerale Schluckmuster kann physiologisch bis zum 4. Lebensjahr bestehen und entwickelt sich graduell in ein somatisches Schluckmuster.

In der Literatur liegen Hinweise vor, dass Lutsch- und Saughabits ein Risiko für die Okklusion darstellen. Je früher ein Lutsch- oder Saughabit aufgegeben wird, desto eher können sich Dysgnathien spontan verbessern oder sogar von selbst korrigieren. Die Ätiologie einer Malokklusion wird primär genetisch und sekundär von umweltbedingten Einflüssen bestimmt. Eingegangen wird hier speziell auf den Kreuzbiss. Die häufigste Ursache für die Entstehung eines Kreuzbisses ist die Reduktion der Breite des maxillären Zahnbogens im Vergleich zur Mandibula, als Resultat von Saughabits, Mundatmung, inkompetentem Lippenschluss, einem viszeralen Schluckmuster und inkorrekter Zungenlage am Mundboden. Ein weiterer Parameter der das Äquilibrium beeinflussen kann, ist die Atmung, bei der Kopf-, Kiefer- und Zungenposition verändert werden. Die myofunktionelle Therapie soll zu einer Verbesserung der Funktion im orofazialen Bereich führen, damit Gesichtsentwicklung, Kieferwachstum und kieferorthopädische Behandlung unbeeinflusst von Dysfunktionen ablaufen können.

Abstract

This article deals with the interaction between tongue, lips and cheeks. Examined parameters are the neutral zone, swallowing patterns, habits, etiology of malocclusions, crossbite, breathing patterns, pressure from the tongue, lips and cheeks and myofunctional therapy.

In the neutral zone teeth are located between the horizontally directed forces of tongue, lips and cheeks, while the teeth are in a stable position. Various parameters such as incorrect swallowing patterns or various habits like pacifier or thumb sucking, can affect the neutral zone. The visceral swallowing pattern can physiologically exist until the fourth year of age and develops gradually into a somatic swallowing pattern.

Respective literature indicates that habits such as pacifier and thumb sucking pose a risk to the occlusion. The earlier these habits are abandoned, the sooner malocclusions can spontaneously improve or even correct themselves. The etiology of a malocclusion is primarily genetically determined and secondary influenced by environmental circumstances. Particular attention has been given to cross-bites. The most common cause for development of a cross-bite is the reduction of the width of the maxillary dental arch compared to the mandible as a result of sucking habits, mouth breathing, incompetent lip closure, visceral swallowing and incorrect tongue position at the base of the mouth. Another parameter that can influence the equilibrium is breathing while the position of head, jaw and tongue are changing. Myofunctional therapy should lead to an improvement of the orofacial function, thus facial development, jaw growth and orthodontic treatment can proceed unaffected by dysfunctions.

Schlüsselwörter

Myofunktionelle Therapie - Schluckmuster - Habits - Atmung

Key words

myofunctional therapy - swallowing pattern - habits - breathing
 

  • Literatur

  • 1 Proffit WR. Equilibrium Theory Revisited: Factors Influencing Position of the Teeth. The Angle Orthodontist 1978; 48: 175 .186
    PubMedGoogle Scholar
  • 2 Weinstein S, Haack DC, Morris LY et al. On An Equilibrium Theory Of Tooth Position. The Angle Orthodontist 1963; 33: 1-26
    PubMedGoogle Scholar
  • 3 Brodie AG. The Fourth Dimension in Orthodontics. Angle Orthodontist 1954; 24: 15-30
    PubMedGoogle Scholar
  • 4 Moyers RE. Handbook of Orthodontics. Chicago: The Year Book Publishers; 1958. pp 93-106
    Google Scholar
  • 5 Dawson PE. Evaluation, Diagnosis, And Treatment Of Occlusal Problems. Mosby Verlag; Chapter 6: The neutral zone pp 72-84
    Google Scholar
  • 6 Peng C, Jost-Brinckmann P, Yoshida N et al. Differential diagnosis between infantile and mature swallowing with ultrasonography. European Journal of Orthodontics 2003; 25: 451-456
    CrossrefPubMedGoogle Scholar
  • 7 Machado Junior AJ, Crespo AN. Radiographic position of the hyoid bone in children with atypical deglutition. European Journal of Orthodontics 2012; 34: 83-87
    CrossrefPubMedGoogle Scholar
  • 8 Christensen M, Hanson M. An investigation of the efficacy of oral myofunktional therapy as a precursor to arctculation therapy for pre-first grade children. Journal of Speech and Hearing Disorders 1981; 46: 160-165
    CrossrefPubMedGoogle Scholar
  • 9 Cayley AS, Tindall AP, Sampson WJ et al. Electropalatographic and cephalometric assessment of tongue function in open bite and non-open bite subjects. European Journal of Orthodontics 2000; 22: 463-474
    CrossrefPubMedGoogle Scholar
  • 10 Swinehart R. The importance of the tongue in the development of normal occlusion. American Journal of Orthodontics and Oral Surgery 1950; 36: 813-830
    PubMedGoogle Scholar
  • 11 Weiss PPW. Auswirkung von Schnullern auf das Gebiss – eine Literaturübersicht. Informationen aus Orthodontie und Kieferorthopädie 2009; 41: 191-198
    PubMedGoogle Scholar
  • 12 Larsson E. The prevalence and aetiology of prolonged dummy and finger-sucking habits. European Journal of Orthodontics 1985; 7: 172-176
    CrossrefPubMedGoogle Scholar
  • 13 Larsson E. Dummy- and finger-sucking habits with special attention to their significance for facial growth and occlusion. 1. Incidence study. Swed Dent J 1971; 64: 667-672
    PubMedGoogle Scholar
  • 14 Vig KWL, Fields HW. Facial growth and management of orthodontic problems. Pediatric Clinics of North America 2000; 47: 1085-1123
    CrossrefPubMedGoogle Scholar
  • 15 Horn H, Kühnast K, Axmann-Krcmar D et al. Influence of orofacial dysfunctions on spatial and temporal dimensions of swallowing movements. Journal of Orofacial Orthopedics 2004; 65: 376-388
    PubMedGoogle Scholar
  • 16 Ogaard B, Larsson E, Lindsten R. The effect of sucking habits, cohort, sex, intercanine widths, and breast or bottle feeding on posterior crossbite in Norwegian and Swedish 3-year-old children. American Journal of Orthodontics and Dentofacial Orthopedics 1994; 106: 161-166
    CrossrefPubMedGoogle Scholar
  • 17 Warren JJ, Bishara SE. Duration of nutritive and nonnutritive sucking behaviors and their effects on the dental arches in the primary dentition. American Journal of Orthodontics and Dentofacial Orthopedics 2002; 121: 347-356
    CrossrefPubMedGoogle Scholar
  • 18 Kerr WJ, McWilliams JS, Linder-Aronson S. Mandibular form and position related to changed mode of bretahing – a five-year longitudinal study. The Angle Orthodontist 1989; 59: 91-96
    PubMedGoogle Scholar
  • 19 Hanson ML, Cohen MS. Effect of form and function an swallowing and the developing dentition. American Journal of Orthodontics 1973; 64: 63-82
    CrossrefPubMedGoogle Scholar
  • 20 Melsen B, Stensgaard K, Pedersen J. Sucking habits and their influence on swallowing pattern and malocclusion. European Journal of Orthodontics 1979; 1: 271-280
    CrossrefPubMedGoogle Scholar
  • 21 Ghafari J, Clark RE, Shofer FS et al. Dental and occlusal characteristics of children with neuromuscular disease. American Journal of Orthodontics and Dentofacial Orthopedics 1988; 93: 126-132
    CrossrefPubMedGoogle Scholar
  • 22 Harvold EP. The role of function in the etiology and treatment of malocclusion. American Journal of Orthodontics 1968; 54: 883-897
    CrossrefPubMedGoogle Scholar
  • 23 Proffit WR, Charstain BB, Norton LA. Linguopalatal pressure in children. American Journal of Orthodontics 1969; 55: 154-166
    CrossrefPubMedGoogle Scholar
  • 24 Proffit WR, McGlone RE, Barrett MJ. Lip and tongue pressures related to dental arch and oral cavity size in Australian aborigines. Journal of Dental Research 1975; 54: 1161-1172
    CrossrefPubMedGoogle Scholar
  • 25 Primozic J, Farcnik F, Perinetti G et al. The association of tongue posture with the dentoalveolar maxillary and mandibular morphology in Class III malocclusion: a controlled study. European Journal of Orthodontics 2013; 35: 388-393
    CrossrefPubMedGoogle Scholar
  • 26 Thilander B, Lennartsson B. A study of children with unilateral posterior crossbite, tretaed and untreated, in the deciduous dentition – occlusal and skeletal characteristics of significance in predicting the long-term outcome. Journam of Orofacial Orthopedics 2002; 63: 371-383
    PubMedGoogle Scholar
  • 27 O’Byrn BL, Sadowsky C, Schneider B et al. An evaluation of mandibular asymmetry in adults with unilateral posterior crossbite. American Journal of Orthodontics and Dentofacial Orthopedics 1995; 107: 394-400
    CrossrefPubMedGoogle Scholar
  • 28 Langberg BJ, Arai K, Miner RM. Transverse skeletal and dental asymmetry in adults with unilateral lingual posterior crossbite. American Journal of Orthodontics and Dentofacial Orthopedics 2005; 127: 6-15
    CrossrefPubMedGoogle Scholar
  • 29 Allen D, Rebellato J, Sheats R et al. Skeletal and dental contributions to posterior crossbites. The Angle Orthodontist 2003; 73: 515-524
    PubMedGoogle Scholar
  • 30 Malandris A, Mahoney EK. Aetiology, diagnosis and treatment of posterior cross-bites in the primary dentition. International Journal of Pediatric Dentistry 2004; 14: 155-166
    CrossrefPubMedGoogle Scholar
  • 31 Primožič J, Ovsenik M, Richmond S et al. Early cross-bite correction: a three-dimensional evaluation. European Journal of Orthodontics 2009; 31: 352-356
    CrossrefPubMedGoogle Scholar
  • 32 Inui M, Fushima K, Sato S. Facial asymmetry in temporomandibular joint disorders. Journal of Oral Rehabilitation 1999; 26: 402-406
    CrossrefPubMedGoogle Scholar
  • 33 Kilic N, Kiki A, Oktay H. Condylar asymmetry in unilateral posterior cross-bite patients. American Journal of Orthodontics and Dentofacial Orthopedics 2008; 133: 382-387
    CrossrefPubMedGoogle Scholar
  • 34 Kiliaridis S, Katsaros C, Raadsheer MC et al. Bilateral masseter muscle thickness in growing individuals with unilateral posterior cross-bite. Journal of Dental Research 2000; 79: 497
    PubMedGoogle Scholar
  • 35 Sonnesen L, Bakke M, Solow B. Bite force in pre-orthodontic children with unilateral cross-bite. European Journal of Orthodontics 2001; 23: 741-749
    CrossrefPubMedGoogle Scholar
  • 36 Ninou S, Stephens C. The early treatment of posterior cross-bites: a review of continuing controversies. Dental Update 1994; 21: 420-426
    PubMedGoogle Scholar
  • 37 Proffit WR. The timing of early treatment: an overview. American Journal of Orthodontics and Dentofacial Orthopedics 2006; 120: 47-49
    PubMedGoogle Scholar
  • 38 Ovsenik M. Incorrect orofacial functions until 5 years of age and their association with posterior cross-bite. American Journal of Orthodontics and Dentofacial Orthopedics 2009; 136: 375-381
    CrossrefPubMedGoogle Scholar
  • 39 Melink S, Vagner MV, Hocevar-Boltezar I et al. Posterior cross-bite in the deciduous dentition period, ist relation with sucking habits, irregular orofacial functions, and otolaryngiological findings. American Journal of Orthodontics and Dentofacial Orthopedics 2010; 138: 32-40
    CrossrefPubMedGoogle Scholar
  • 40 Ovsenik M, Volk J, Mušič Marolt M. A 2D ultrasound evaluation of swallowing on children with unilateral posterior crossbite. European Journal of Orthodontics 2014; 36: 665-671
    CrossrefPubMedGoogle Scholar
  • 41 Volk J, Kadivec M, Mušič Marolt M et al. Three-dimensional ultrasound diagnostics of tongue posture in children with unilateral posterior crossbite. American Journal of Orthodontics and Dentofacial Orthopedics 2010; 138: 608-612
    CrossrefPubMedGoogle Scholar
  • 42 Primožič J, Richmond S, Kau CH et al. Three-dimensional evaluation of early crossbite correction: a longitudinal study. European Journal of Orthodontics 2013; 35: 7-13
    CrossrefPubMedGoogle Scholar
  • 43 Solow B, Tallgren A. Head posture and craniofacial morphology. Am J Phys Anthropol 1976; 44: 417-436
    CrossrefPubMedGoogle Scholar
  • 44 Lione R, Franchi L, Ghislanzoni LTH et al. Palatal surface and volume in mouth breathing subjects evaluated with three-dimensional analysis of digital dental casts – a controlled study. European Journal of Orthodontics 2015; 101-104
    PubMedGoogle Scholar
  • 45 Fröhlich K, Thüer U, Ingervall B. Pressure from the tongue on the teeth in young adults. The Angle Orthodontist 1990; 61: 17-24
    PubMedGoogle Scholar
  • 46 Hahn V, Hahn H. Zehn-Jahresstudie über die Effizienz der myofunktionellen Therapie. Informationen aus Orthodontie und Kieferorthopädie 1992; 24: 573-578
    PubMedGoogle Scholar
  • 47 Ohono T, Yogosawa F, Nakamura K. An approach to open bite cases with tongue thrusting habits – with reference to habit appliance and myofunctional therapy as viewed from an ortodontic standpoint: part one. Int Journal of Orofacial Myology 1981; 7: 10-13
    PubMedGoogle Scholar
  • 48 Padovan BA. Neurofunctional reorganization in myo-osteo-dentofacial disorders: complementary roles of orthodontics, speech and myofunctional therapy. Int Journal of Orofacial Myology 1995; 21: 33-40
    PubMedGoogle Scholar
  • 49 Tränkmann J, Rixe K. Nachuntersuchung dyskinesiebedingter Dysgnathien nach myofunktioneller Therapie. Fortschr Kieferorthopädie 1995; 56: 67-76
    PubMedGoogle Scholar
  • 50 Tränkmann J. Kieferorthopädische Misserfolge nach übersehenen Dyskinesien. Fortschr Kieferorthopädie 1988; 49: 388-399
    PubMedGoogle Scholar
  • 51 Proffit WR, Brandt S, William R. Proffit on the proper role of myofunctional therapy. J Clin Orthod 1977; 11: 101-105
    PubMedGoogle Scholar
  • 52 Sergl HG. 15 Thesen zur aktuellen Situation der myofunktionellen Therapie. Fortschr Kieferorthopädie 1988; 49: 312-314
    PubMedGoogle Scholar
  • 53 Stöckli PW, Ingervall VB, Joho JP et al. Myofunktionelle Therapie. Fortschr Kieferorthopädie 1987; 48: 460-463
    PubMedGoogle Scholar
  • 54 Giesecke K, Berten JL, Tränkmann J. Die myofunktionelle Therapie als präventive und unterstützende Maßnahme bei der kieferorthopädischen Überwachung und Behandlung. Prakt Kieferorthopädie 1988; 2: 31-38
    PubMedGoogle Scholar
  • 55 Obijou N, Reinicke C, Tränkmann J. Myofunktionelle Therapie als kieferorthopädische Vorbehandlung bei Dyskinesie bedingten Dysgnathien. Kieferorthopädie 1997; 11: 291-298
    PubMedGoogle Scholar
  • 56 Weiss CE, Van Houten JT. A remedial program for tongue-thrust. American Journal of Orthodontics 1972; 62: 500-506
    PubMedGoogle Scholar
  • 57 Fischer-Voosholz M, Spenthof U. Orofaziale Muskelfunktionsstörungen: Klinik-Diagnostik-ganzheitliche Therapie. Springer Verlag; 2002. Kapitel 8: Therapie 86-155
    CrossrefGoogle Scholar
  • 58 Van Dyck C, Dekeyser A, Vantricht E et al. The effect of orofacial myofunctional treatment in children with anterior open bite and tongue dysfunction: a pilot study. European Journal of Orthodontics 2015; 1-8
    PubMedGoogle Scholar
  • 59 Ingervall B, Eliasson GB. Effect of Lip Training in Children with Short Upper Lip. The Angle Ortodontist 1982; 52: 222-233
    PubMedGoogle Scholar