Palatal Plate Therapy In Children with Down Syndrome: A Systematic Review Of Literature

Background: The oro-facial abnormalities in children with Down syndrome (DS) can be managed through oro-facial therapy using a palatal plate. The present review aimed to investigate the frequency, duration, and type of palatal plates with their different stimulation elements in palatal plates therapy used in early infancy in children with DS. Methods: Electronic databases including Medline (via PubMed), The Cochrane Library (CENTRAL) and Scopus were searched. Only studies published in English during the last twenty years describing the effects of palatal plate therapy (PPT) on oral motor function were included. The ROBINS-I tool was used to assess the quality of the methodology of the included studies. Results: Six studies were retained, included a total of 300 children with DS with a mean age ranged between 2 months and 13 years. All children in the PPT reported a significant improvement of the memetic muscles, tongue retraction and significant longer lip closure. The children in the palatal plate therapy group were treated with modified palatal plates according to Castillo Morales. Different palatal plates were used, and the PPT frequencies were ranged between 2 and 3 times daily for 5 to 60 minutes with a duration ranged from 12 to 48 months. Conclusion: All the included studies in the present review, reported that palatal plates designed in accordance with the shape of Castillo-Morales basic plates when used before 3 months of age and for several minutes a day combination with orofacial physiotherapy, improved the orofacial disorders in children with DS.