Electropalatographic and cephalometric assessment of tongue function in open bite and non-open bite subjects.

Anterior open bite (AOB) and tongue thrust swallowing are frequently associated, but the relationship between the two remains unclear. Electropalatography (EPG), which is used in speech pathology to measure dynamic tongue function for diagnostic, therapeutic, and research purposes, is a suitable technique for the investigation of this relationship. The present clinical study examined the dentofacial pattern and tongue function in AOB and non-open bite children. EPG recordings of speech and swallowing, and lateral head radiographs were obtained from eight 10-year-old boys with tongue thrust swallowing behaviour and AOB, and from eight age-matched non-open bite controls. Analysis of data from the two groups indicated that although differences were small, the open bite children displayed trends for longer face morphology and greater upper incisor proclination, less consistent production of closures during speech, a more posterior pattern of EPG contact, and relatively sparse EPG contact during swallowing. The discovery of differing patterns of contact for the /d[symbol: see text]/ and /t[symbol: see text]/ phonemes indicates that these should be included when speech is used to test for the presence of fronted tongue behaviour.

Electropalatographic and cephalometric assessment of myofunctional therapy in open-bite subjects.

Myofunctional therapy (MFT) is often prescribed to correct tongue-thrust swallowing, with the expectation that anterior open bite (AOB) will reduce spontaneously if a more posterior tongue posture is learned. However, MFT has not been subjected to systematic evaluation. Electropalatography (EPG), which is used in speech pathology to measure dynamic tongue function for diagnostic, therapeutic and research purposes, is a suitable technique for the evaluation of MFT. This prospective clinical study assessed the effect of tongue re-education therapy on tongue function and dento-facial form in AOB patients. Electropalatography recordings of speech and swallowing, and lateral head cephalometric radiographs were obtained from eight 10-year-old boys with tongue-thrust swallowing behavior and AOB before and after a course of tongue re-education therapy. Although differences in cephalometric measurements before and after therapy were small, there was some evidence of a trend for upper and lower incisor eruption, with concomitant reduction of the AOB. Analysis of the EPG speech data was inconclusive, but the swallowing data showed trends for more consistent and more anterior patterns of EPG contact after therapy. Comparison of pre- and post-therapy EPG data with data from a parallel study using a group of age-matched controls indicated that some "normalisation" of swallowing behaviour had occurred. The results of this research imply that the therapy was partially successful in improving tongue function during swallowing and in reducing AOB. Further research on a larger sample over a longer observation period is required for more accurate assessment of soft and hard tissue changes.

The influence of audit on the diagnosis of occlusal caries.

Audit is widely used to improve the quality of care in both medicine and dentistry but has not always been subject to systematic evaluation. The aim of this study was to assess the effect of an audit exercise on the diagnosis of occlusal caries. Using combined visual and radiographic methods. 11 dentists assessed 60 extracted molars for occlusal caries on two occasions. An audit exercise, in the form of a meeting, was carried out in the intervening period. Inter- and intra-examiner reproducibility were estimated for each of the two examinations. Validation was through a gold standard set up by sectioning the teeth. Wide diagnostic disparity was seen at both examinations, all inter- and intra-examiner kappa values were below 0.73. Intra-examiner kappa values increased significantly on the second occasion. Mean sensitivity and specificity were 0.65 and 0.74, respectively, at the first examination and 0.65 and 0.72 at the second. No changes were seen that could be attributed directly to the audit exercise but practising the diagnostic test appeared to be beneficial to intra-examiner reproducibility of diagnosis.