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DOI: 10.1055/s-0042-103451
Äquilibrium von Zunge, Lippen und Wangen
Equilibrium between Tongue, Lips and CheeksPublikationsverlauf
Publikationsdatum:
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.
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