Orofasiyal kas disfonksiyonu olan engelli çocuklarda Castillo-Morales apareyinin konuşma gelişimi üzerine etkisi
Effects of the Castillo-Morales stimulating plate on speech development of children with orofasiyal muscle dysfunction
Yazar: SİBEL POLAT
Danışman: PROF.DR. ALEV ALAÇAM
Gazi Üniversitesi / Sağlık Bilimleri Enstitüsü / Pedodonti Ana Bilim Dalı
Derece: Doktora, 2007
Konu: Diş Hekimliği = Dentistry

Özet:
Bu ~allgmada orofasiyal kas disfonksiyonu bulunanengelli ~ocuklarda 12 ay sureli Castillo-Morales palatal plaktedavisinin fonksiyonel geligim uzerine katk~lan ve sonuglann~ocuklannk onugma ve yumugak doku geligimi iizerindeki etkisinindegerlendirilmesi ama~land~.Callgma yaglan 3-1 3 araslnda orofasiyal kasdisfonksiyonu bulunan 30 gocuk uzerinde yiirutuldu. Tedaviyikabul eden ve gal~~mgraub una al~nan1 9 ~ocuikle kontrol grubunaal~nan1 1 ~ocugunfo nsiyonel degi~imlerib aglang~g, 6. ve 12.aylarda Oreland kriterlerine gSre degerlendirildi. Yap~lante davininsonuglannln gocuklann konugma geligimi uzerine etkisi analizyap~labilene al~gmag rubundan 14, kontrol grubundan ise 7 qocugaAAT ile degerlendirildi. Cocuklann yuz ifadelerindeki geligmelertedavinin baglanglc~ndav e sonunda al~nanfo tograflarla belirlendi.Yumugak doku geligimine ait degerlendirmeler, 12. ay sonundalateral sefalometrik analiz yap~labilen1 0 ~ocukuz erinde Steiner'lnS ~izgisineg ore yap~ld~Te. davi ba~langlclndav e sonunda al~nanvideo kay~ot mekleri ile gal~gmav e kontrol grubundaki gocuklannFischer-Brandiesye gbre dil pozisyonlan ve Jackson'ln dudaksln~flamaslna gore dudak pozisyonlan belirlendi. Oral fonksiyon,konugma geligimi ve yumugak doku geligimine aitdegerlendirmelerin analizi istatistiksel olarak degerlendirildi.Castillo-Morales apareyini kullanan qocuklardaorofasiyal kas fonksiyonlannda onemli bir gelifim sagland~g~,Steiner'in S gizgisine gbre yumugak doku degerlendirmesi vevideo kay~tlanna gore yapllan dudak ve dil pozisyonudegerlendirmeleri ve fotograflarla apareyin yuz profili geligimindekiolumlu rolunun belirlendigi, aynca yap~lan AAT ile konu~mageligimi degerlendirmesi sonucunda aparey kullanan gocuklardakonugma terapisi surecine olumlu katk~sa glandla1 saptand~.Anahtar Kelimeler: Castillo-Morales, orofasiyal kas disfonksiyonu,konugma geligimi, gocuk

Abstract:
In this study, it was aimed to determine thecontribution of 12 months of Castillo-Morales palatal plate therapyto functional development as well as the effects of the results onspeech and soft tissue development in handicapped childrenhaving orofacial muscle dysfunctions.The study was conducted on 30 children havingorofacial muscle dysfunctions with ages between 3-13 yean.Functional alterations in 19 children of study group who acceptedto have the treatment and I 1 children of control group wereassessed at baseline, 6th and 12'~ months according to Orelandcriteria. The effects of treatment results on speech development ofchildren were evaluated in 14 children from study group and 7children from control group by Ankara Articulation Test. Theimprovements in terms of facial expression in children weredetermined with photographs taken at the beginning and at theend of therapy. Assessment of soft tissue development wascarried out on 10 children analyzed with lateral sefalometricanalysis according to Steiner's S line. Tongue positions according .to Fischer-Brandies and lip positions according to Jackson lipclassification were determined in children from both study andcontrol groups by video registration samples recorded at thebeginning and at the end of therapy. The analysis of evaluations oforal function, speech and soft tissue development were madestatistically.In conclusion, it was found that an outstandingimprovement at orofacial dysfunctions was achieved in childrenusing Castillo-Morales appliance and that the positive role ofappliance on development of facial profile could be determinedwith soft tissue evaluation according to Steiner's S line and withlip and tongue position assessments according to videoregistration as well as photographs. Furthermore, the results ofevaluation of speech development by AAT showed that appliancetherapy contributed positively to speech therapy period.Key words: Castllo-Morales, orofacial muscle dysfunction,speech development, children