Swallowing process
- Hyoid bone has to go up and down to swallow to produce a vacuum
- Molars have to be in contact
- Suprahyoid muscles required to elevate hyoid bone
- Infra hyhoid bone required to depress hyoid bone
Relapse of AOB
20% Greenlee 2011 S/R
Unless new neuromuscular engram established
- Reflex arc – how we respond to harm
- Placing a nail in a door – we receive a stimulus of pain
- Change motor response
- =Learned engram
- Relapse due to continuous tongue position – posture of the tongue, not functional
Investigation stability of AOB Justus 1990
- Spur relapse 17% growing patient, 0% in non-growing patients
- Non spurs: 35-43% relapse
Ext Vs non-ext for AOB: more stable with extraction: Janson
- Contraindications:
- Lip incompetence
- Poor muscular control
- Unerupted lateral incisors
Conclusions
- Spurs increase stability