Tongue myofunctional performance, strength and functionality index in Class II and Class III dentofacial deformities

Individuals with dentofacial deformities (DFD) present several orofacial myofunctional alterations. However, the characteristics of tongue position and motor performance, which are crucial for DFD assessment and treatment, remain poorly understood.

To assess orofacial myofunctional status and analyze tongue position, mobility, behavior during swallowing, and pressure/strength performance in patients with Class II and Class III DFD compared with control subjects, as well as to formulate a tongue functionality index.

Fifty-six patients with DFD were divided into two groups: Class II DFD (CII, n = 26) and Class III DFD (CIII, n = 30). Nineteen healthy individuals composed the control group. All participants were evaluated using the Orofacial Myofunctional Evaluation with Scores (OMES) protocol and the Iowa Oral Performance Instrument (IOPI) for tongue strength measurements. The tongue functionality index was obtained by summing the z-scores of the total tongue score and saliva-swallowing strength.

Patients with DFD showed lower total OMES scores (indicating worse performance), lower tongue performance scores, and reduced tongue strength during swallowing (P < .01). The tongue functionality index demonstrated excellent diagnostic accuracy and sensitivity, as well as good specificity, in differentiating the tongue status of patients with and without DFD.

The individuals from groups CII and CIII exhibited global orofacial myofunctional alterations, impaired tongue position and motor ability, and reduced tongue strength during swallowing. The tongue functionality index may serve as a useful variable for predicting tongue functional status.