Effectiveness of an adapted Interdisciplinary Orofacial Examination Protocol for Children and Adolescents for the Early Identification of Speech Disorders in Paediatric Orthodontic Patients.

内容摘要

Orofacial Myofunctional Disorders (OMDs) affect oral functions and influence craniofacial development, contributing to skeletal and dental malocclusions. The collaboration between orthodontists and speech-language pathologists (SLPs) is crucial for early diagnosis and comprehensive treatment. This study aims to evaluate the diagnostic competence of orthodontic residents in identifying OMDs, and to determine whether the application of a standardised interdisciplinary orofacial assessment protocol enhances diagnostic accuracy and interprofessional consistency. Twenty-nine postgraduate orthodontic residents (PORs) at the University of Pavia were asked to conduct the first visit of one patient each to assign a Diagnostic Score (DS) from 1 to 10, where 1 indicated no need for intervention and 10 indicated an absolute necessity for orofacial myofunctional therapy (T0). Subsequently, an adapted version of the Interdisciplinary Orofacial Examination Protocol for Children and Adolescents (aIOEPCA) was used to improve the diagnostic ability of PORs. aIOEPCA comprised 15 clinical items, including assessment of sagittal, vertical, and transverse malocclusion patterns, lip competence, tongue mobility, breathing, swallowing, and speech articulation-each scored to quantify the severity of dysfunction. A second evaluation of the DS was conducted after the use of the protocol (T1), to assess improvements in PORs diagnostic ability. An expert SLP independently evaluated the same patients using the interdisciplinary protocol and DS were compared. Statistically significant differences (p < 0.05) were observed between the PORs and the SLP evaluations across several functional parameters. Regarding DS, a significant difference was found between PORs T0 and SLP (p < 0.05), while after the use of the protocol the score improved, and PORs T1 vs SLP resulted not significant (p > 0.05). The use of the aIOEPCA improved diagnostic consistency, highlighting its potential as a standardised interdisciplinary diagnostic tool. The findings highlight a deficiency in the ability of orthodontic residents to identify functional impairments requiring orofacial myofunctional therapy. Implementing interdisciplinary assessment tools could help to mitigate this deficit and foster more cohesive diagnostic pathways. Structured interprofessional education should be considered an imperative part of orthodontic education.