Seminars in Orthodontics

VOL 16, NO 2

JUNE 2010

Introduction
n general, when orthodontists discuss the importance of the orofacial soft tissues with
regard to the etiology and prognosis for treatment of malocclusion, they immediately think of
the muscles of facial expression, including the
lips, cheeks, and tongue. The part played by the
muscles of mastication tends to be forgotten or,
at best, ill-understood. Nevertheless, the muscles
of mastication may play pivotal roles, not only in
contributing to the etiology of a malocclusion,
but also from the point of view of the application
of treatment mechanics and the potential success of treatment outcomes. Several research
groups around the world are now focusing on
these important structures. This issue of the
journal is designed to provide an overview of
recent research into the significance of the
craniofacial muscles as they impact on orthodontics and future patient care.
The first few articles focus on etiology and
consider the evidence as to whether craniofacial
muscles are the driving force behind normal or
abnormal facial development, or, alternatively,
whether the structural and functional differences seen in the muscles, are an adaptive response to the underlying, abnormal skeletal, and
dental relationships. The respective authors
present modern, cogent, high-quality research
in support of the 2 schools of thought. These

cover animal studies as well as human clinical

and molecular biological investigations.
Irrespective of whether the muscles of mastication are involved in etiology, there is no doubt
that appropriate muscle adaptation is fundamental to the success of many treatment approaches. These include the use of myofunctional orthopedic appliances as well as combined
orthodontic/orthognathic surgical treatment. It
is essential that the practicing specialist understands the mechanisms behind muscle adaptation and, in particular, how these relate to the
unique structure of the craniofacially derived
muscle tissues. The subsequent articles, therefore, review our current knowledge of the muscle adaptive processes, which involve both the
contractile elements and the equally important
connective tissue component, the extracellular
matrix.
A change of treatment approach and its underlying philosophy through the possible development and application of new technologies to
further enhance tooth movement, facial growth,
muscle adaptation, and ultimately treatment
outcome are also discussed. Finally, as we move
further into the age of tissue engineering, a
review of the techniques currently being developed for the regeneration of functioning, human, muscular tissue is presented, and which
have the potential to complete the translation
from laboratory research to clinical practice.

2010 Elsevier Inc. All rights reserved.

doi:10.1053/j.sodo.2010.02.009

Seminars in Orthodontics, Vol 16, No 2 (June), 2010: p 91

Nigel P. Hunt
Guest Editor

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