Systematic Review
 

By Dr. Martina Dari , Dr. Elisa Pacella , Dr. Denise Giovannoni , Dr. Ludovica Caterini , Dr. Martina Mezio
Corresponding Author Dr. Martina Dari
Department of Oral and Maxillo Facial Sciences, La Sapienza , Orthognathodontics Unit-Italy, - Italy
Submitting Author Dr. Martina Dari
Other Authors Dr. Elisa Pacella
Department of Oral and Maxillo Facial Sciences, La Sapienza , Orthognathodontics Unit-Italy, - Italy

Dr. Denise Giovannoni
Department of Oral and Maxillo Facial Sciences, La Sapienza , Orthognathodontics Unit-Italy, - Italy

Dr. Ludovica Caterini
Department of Oral and Maxillo Facial Sciences, La Sapienza , Orthognathodontics Unit-Italy, - Italy

Dr. Martina Mezio
Department of Oral and Maxillo Facial Sciences, La Sapienza , Orthognathodontics Unit-Italy, - Italy

ORTHODONTICS

Myobrace, orthodontic, interceptive , elastomeric , myofunctional , appliance

Dari M, Pacella E, Giovannoni D, Caterini L, Mezio M. Myobrace: functional and dental effect in the same device. WebmedCentral ORTHODONTICS 2017;8(11):WMC005353

This is an open-access article distributed under the terms of the Creative Commons Attribution License(CC-BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
No
Submitted on: 26 Oct 2017 06:45:15 PM GMT
Published on: 08 Nov 2017 05:50:06 AM GMT

Abstract


The interceptive and/or preventive orthodontic is a treatment used in primary and mixed
dentition. Myobrace is a removed, preformed appliance that can be used to treat malocclusion
during the growing period. It is built with the purpose of joining the benefits of a functional
appliance with the alignment effect. The aim of this work is to describe the appliance: its use, its
therapeutic indication and the mode of use.

Background


Myobrace is an appliance produced by Myofunctional Reasearch Co. (MRC Myofunctional
Research Co., Queensland, Australia), a group that for 20 years studied and projected orthodontic
devices in order to treat malocclusions by myo-functional education and by removing the soft
tissue dysfunctions. Functional orthodontic believes that functions are guided by form and that
malocclusions are often caused by incorrect myo-functional habits. As a result of this, if a patient
has a correct breathing, swelling and tongue position, the jaws and the arches can grow balanced.
If not (for example in case of oral breathing) a malocclusion can occur.

Discussion


The Myobrace system is an evolution of a previous appliance, the Training Sistem (TS). Myobrace
joins in one device the functions of habit correction, arch development, dental alignment and then
retention.
The Myobrace system is designed for different stages of dentition, so it can be used in a big range
of patients (from kids to adult): Myobrace for junior system can be used during primary dentition,
Myobrace for Kids or for Teen during mixed dentition (the first for early mixed dentition, the
second for late mixed dentition), Myobrace for adult during permanent dentition.

Myobrace is a single block appliance for both the arches, it is made in elastomeric material.

The main components are:

a)Soft outer structure:inspired by Trainer System with improved characteristics, gives
comfort and adaptability to the structure.
b)Dynamicore:is the inner core that guides arch development. The "Dynamicore" is a nylon
element and it is the main difference from the Training System. It has different functions: it
makes labial and buccal shields stronger in order to increase the arch's expansion by
removing the force of perioral and buccinator muscles and it exerts forces on the teeth to
guide them in their correct position.
c)Tooth slot:the appliance has different slots to guide the teeth in a correct first class
relationship, without crowing them. The guiding effect is greater during teeth eruption,
with the possibility to correct more severe crowding and less risk of relapses. Indeed, the
periodontal ligament matures completely after teeth eruption: so if the teeth erupt in the
correct position, the periodontal ligament is able to mature around the teeth that are in a
right and stable position.
d)Labial and buccal shields:the purpose of these shields is to turn away the pressure of the
lips and the cheeks, so that arches can develop. They can be used to correct the habit of
sucking finger or lips.
e)Tongue tag:it is positioned behind anterior incisors, where there is the palatine papilla.
The aim is to educate the correct swallowing by giving a target to the patient. In this way
the tongue is guided in the correct position during the activity(swallowing) and when it is
passive.
f)Tongue guard and elevators: removes the tongue interposition during shallowing and
guides it in the correct position.
g)Extended Lip bumber and high sides: discourages overactive lip function and encourages
nasal breathing.

Myobrace works in four stages: habit correction, arch development dental alignment and
retention. The habit correction function can be increased with functional exercises that
encouraging nasal breathing, correct tongue position and swallowing as well as strengthening and
developing of orofacial musculature. The arch development and the dental alignment are achieved
by the labial and buccal shields that turn away the pressure of perioral and buccinator muscles
and by the tongue education that allows the arches development and the alignment of the teeth.

Retention is very important in Myofunctional Philosophy: if the alignment is achieved with a
myofunctional education, the function itself can avoid the relapse.
Myobrace can be used to treat first class malocclusions with open bite or deep bite, second class
malocclusions (first and second division) and to remove oral habits.
The appliance must be used during the whole night and 1-2 hours at daytime. During the daily
phase, it is important that the appliance is worn in the right mode to train the correct night use.
The instructions to be followed are: lips must be closed anytime except when speaking; breathing
must happen through the nose; there must not be lip activity when swallowing.
This device can be used during sport activity too (except during aquatic sport like swimming) and it
can also function as mouthguard.
Myo-Brace, unlike Training System (that exists only is one size), exists in seven different sizes. The
proper size is chosen with a special ruler. The ruler measures the size of the anterior teeth (from
distal margin of later incisor of one side to the distal margin of lateral incisor of the other side).
The ruler must be placed in direct contact with the teeth, so it is better to measure on the plaster
model too. If crowding or diastemas prevent the correct measuring, it's better to measure the
single tooth sizes with a normal ruler and sum them to find the matching size. If the choice is in
the middle between two different sizes it's better to choose the largest one.

Conclusion(s)


Myo-Brace is a valid appliance that can be used to treat many clinical problems. The union of the
myofunctional therapy and the teeth alignment effect in a single device allows it to fit to different
patients especially during the growing period. A study shows that patients using a guidance
appliance during the eruption period need fixed therapy less and if they need it, the treatment
period is shorter.

Reference


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Source(s) of Funding


No found has been taken.

Competing Interests


None

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