Reliability and Validity of the Italian Version of the Protocol of Orofacial Myofunctional Evaluation with Scores (I-OMES).

OBJECTIVE: To evaluate the reliability, validity, and responsiveness of the Italian OMES (I-OMES). PATIENTS AND METHODS: The study consisted of 3 phases: (1) internal consistency and reliability, (2) validity, and (3) responsiveness analysis. The recruited population included 27 patients with orofacial myofunctional disorders (OMD) and 174 healthy volunteers. Forty-seven subjects, 18 healthy and all recruited patients with OMD were assessed for inter-rater and test-retest reliability analysis. I-OMES and Nordic Orofacial Test - Screening (NOT-S) scores of the patients were correlated for concurrent validity analysis. I-OMES scores from 27 patients with OMD and 27 age- and gender-matched healthy subjects were compared to investigate construct validity. I-OMES scores before and after successful swallowing rehabilitation in patients were compared for responsiveness analysis. RESULTS: Adequate internal consistency (Cronbach α = 0.71) and strong inter-rater and test-retest reliability (intraclass coefficient correlation = 0.97 and 0.98, respectively) were found. I-OMES and NOT-S scores significantly and inversely correlated (r = -0.38). A statistical significance (p < 0.001) was found between the pathological group and the control group for the total I-OMES score. The mean I-OMES score improved from 90 (78-102) to 99 (89-103) after myofunctional rehabilitation (p < 0.001). CONCLUSION: The I-OMES is a reliable and valid tool to evaluate OMD.

An index for the evaluation of 3D masticatory cycles stability.

OBJECTIVES: To introduce an index (Masticatory Stability Index, MSI) to analyze the stability of chewing cycles in standardized conditions and test it in a group of patients with subclinical mild temporomandibular disorder (TMD). DESIGN: 23 subjects with mild subacute TMD and 21 healthy subjects were involved; they all responded to a questionnaire about signs and symptoms of TMD (ProTMDmulti) and underwent a myofunctional orofacial evaluation with scores, using the protocol of orofacial myofunctional evaluation with scores (OMES). Their mandibular kinematics was assessed with a 3D motion capture system during deliberate unilateral gum chewing. The MSI was computed synthesizing the information contained in nine kinematics parameters into a single global figure. Patients' and controls' MSI were compared considering the preferred and non-preferred chewing side using a 2-way ANOVA (factors: group, side). RESULTS: Together with a lower total score of myofunctional orofacial status, the TMD group showed a reduced stability based on MSI (p<0.05). CONCLUSIONS: The MSI is an efficient method to measure the stability of the masticatory cycles. These preliminary results encourage validating the index on a larger sample. The variability in the motor behavior of chewing can impair the objectivity of its evaluations in several types of patients, including those with TMD. The MSI could be useful to complement clinical assessments, providing data for planning the rehabilitation of masticatory function in these patients.