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Examination of the Relationship Between Mandibular Position and Body Posture

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Abstract

The purpose of this study was to evaluate the effect of changing mandibular position on body posture and reciprocally, body posture on mandibular position. Forty-five (45) asymptomatic subjects (24 males and 21 females, ages 21-53 years, mean age 30.7 years) were included in this study and randomly assigned to one of two groups, based on the table of random numbers. The only difference between group I and group II was the sequence of the testing. The MatScan (Tekscan, Inc., South Boston, MA) system was used to measure the result of changes in body posture (center of foot pressure: COP) while subjects maintained the following 5 mandibular positions: (1) rest position, (2) centric occlusion, (3) clinically midlined jaw position with the labial frena aligned, (4) a placebo wax appliance, worn around the labial surfaces of the teeth and (5) right eccentric mandibular position. The T-Scan II (Tekscan, Inc., South Boston, MA) system was used to analyze occlusal force distribution in two postural positions, with and without a heel lift under the right foot. Total trajectory length of COP in centric occlusion was shorter than in the rest position (p < 0.05). COP area in right eccentric mandibular position was larger than in centric occlusion (p < 0.05). When subjects used a heel lift under the right foot, occlusal forces shifted to the right side compared to no heel lift (p < 0.01). Based on these findings, it was concluded that changing mandibular position affected body posture. Conversely, changing body posture affected mandibular position.
... However, this is a contentious topic in the scientific community. There is evidence both supporting such a relationship [15][16][17][18][19][20] and refuting it [21][22][23][24]. ...
... Given the high proportion of patients with malocclusion [19,20] and the contradictory reports concerning the relationships in question [15][16][17][18][19][20][21][22][23][24], the need for further knowledge and analysis of individual malocclusions and accompanying musculoskeletal abnormalities in dynamic and static conditions is reasonable. There is still a lack of research regarding the effect of occlusion on postural stability and plantar pressure distribution during standing and gait in the same group of adults with Angle Class I, II and III. ...
... There were also attempts to determine the impact of the stomatognathic system on postural control. In this case, however, many results confirming and refuting this impact are observed, including many studies with a small number of parameters tested [15][16][17]20,22,33]. Most studies report on the impact of artificially induced occlusal changes on the postural stability of subjects [42]. ...
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Background: There is still an ongoing debate about the role of the craniomandibular system, including occlusal conditions, on postural stability. This study aims to assess the role of antero-posterior malocclusion on postural control and plantar pressure distribution during standing and walking. Methods: 90 healthy volunteers (aged 19 to 35) were qualified for the study. The subjects were assigned to three groups, depending on the occlusion type. Each group (Angle Class I, II and III) consisted of 30 people. The research procedure included a clinical occlusal assessment performed by a dentist. Postural control measurements were carried out using a force platform by measuring plantar pressure distribution during standing (six trials with and without visual control) and walking test conditions. Results: The tendency to shift the CoP forward is demonstrated by Angle Class II subjects and backwards by Class I and III subjects (p < 0.001). Individuals with a malocclusion demonstrated significantly higher selected stabilographic parameters while standing on both feet (with eyes open and closed) and during the single-leg test with eyes open (p < 0.05). The analysis of the dynamic test results showed no significant correlations between Angle Classes and the selected gait parameters. Conclusions: Analyses conducted among individuals with malocclusions showed the impact of occlusion on static postural stability. In order to diagnose and effectively treat malocclusion, a multidisciplinary approach with the participation of dentists and physiotherapy specialists is necessary, with the use of stabilometric and kinematic posture assessments.
... The relationship between occlusion and posture is supported by the extensive statistical evidence from observations and experimental data [1,2,3] and temporomandibular joints (TMJ) could be an outer entrance of postural regulation [1,4] as are the eyes [5] , feet, and even spatial hearing [6] . For example, a disruption of these balance sensors may be responsible for postural impairment syndrome, which is characterized by symptoms ranging from mobility restriction, dizziness, and tinnitus, and that may potentially be painful [7] . ...
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Occlusal treatments can cause irreversible dental changes without guaranteeing clinical success. To avoid this, an initial, non-mutilating, phase of treatment using splint, for example, followed by an objective evaluation of the effectiveness is required before moving to next phase that permanently freezes the new mandibular position. As an example, a 74 years-old European female who consulted for tinnitus was referred, prior to any procedure, to a posturologist who established an initial postural assessment. A splint was made to increase the height between posterior teeth. 6 months after the tinnitus had disappeared, the patient was sent for postural assessment (made by the same posturologist and using the same tests). After an additional increase in posterior teeth height validated by an additional postural analysis, new fixed prostheses were placed taking into account the respective increases in height validated during this initial phase of treatment. Monitoring the effectiveness of initial and reversible stage is important as in occlusodontology, the disappearance of clinical symptoms is not always synonymous with healing. Moreover this is an interesting way to improve the rigor of patient management.
... A frequently cited explanation for this is based on the stimulation of periodontal mechanoreceptors that are centrally integrated along with other sensory input and, therefore, facilitates the excitability of the human motor system (Boroojerdi et al., 2000) in a manner similar to the Jendrassik maneuver (Jendrassik, 1885), which in turn increases the neural drive to the distal muscles (Ebben, 2006;Ebben et al., 2008). A variety of studies indicated that stomatognathic motor activity in the form of chewing, tongue activity or different clenching conditions affects human balance and posture under static conditions (Gangloff et al., 2000;Sakaguchi et al., 2007;Hellmann et al., 2011Hellmann et al., , 2015Alghadir et al., 2015;Ringhof et al., 2015a,b). Among others, a reduced body sway in the anteriorposterior direction (Hellmann et al., 2011), a reduced variability of muscular co-contraction patterns of posture-relevant muscles of the lower extremities (Hellmann et al., 2015), and reduced trunk and head sway under the influence of controlled biting activities were reported during upright standing (Ringhof et al., 2015a). ...
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Multiple sensory signals from visual, somatosensory and vestibular systems are used for human postural control. To maintain postural stability, the central nervous system keeps the center of mass (CoM) within the base of support. The influence of the stomatognathic motor system on postural control has been established under static conditions, but it has not yet been investigated during dynamic steady-state balance. The purpose of the study was to investigate the effects of controlled stomatognathic motor activity on the control and stability of the CoM during dynamic steady-state balance. A total of 48 physically active and healthy adults were assigned to three groups with different stomatognathic motor conditions: jaw clenching, tongue pressing and habitual stomatognathic behavior. Dynamic steady-state balance was assessed using an oscillating platform and the kinematic data were collected with a 3D motion capturing system. The path length (PL) of the 3D CoM trajectory was used for quantifying CoM sway. Temporal dynamics of the CoM movement was assessed with a detrended fluctuation analysis (DFA). An uncontrolled manifold (UCM) analysis was applied to assess the stability and control of the CoM with a subject-specific anthropometric 3D model. The statistical analysis revealed that the groups did not differ significantly in PL, DFA scaling exponents or UCM parameters. The results indicated that deliberate jaw clenching or tongue pressing did not seem to affect the sway, control or stability of the CoM on an oscillating platform significantly. Because of the task-specificity of balance, further research investigating the effects of stomatognathic motor activities on dynamic steady-state balance with different movement tasks are needed. Additionally, further analysis by use of muscle synergies or co-contractions may reveal effects on the level of muscles, which were not visible on the level of kinematics. This study can contribute to the understanding of postural control mechanisms, particularly in relation to stomatognathic motor activities and under dynamic conditions.
... Dental research [4,5] has identified that posture and lower leg length inequality has the ascending effect of altering occlusion. The Aqualizer® splint appears to be an easy tool in the diagnostic workup to screen for malocclusion as an important driver for a descending effect in the causation of neck and back pain by PTs. ...
... 5 There are a variety of studies indicating an influence of stomatognatic motor activity in the form of chewing, tongue activity or different clenching conditions in different jaw relations on human balance and posture under static conditions. [5][6][7][8][9][10][11][12] This means, in particular, a reduced body sway in the anterior-posterior direction, 8 a reduced variability of muscular co-contraction patterns of posture-relevant muscles of the lower extremities and reduced trunk and head sway under the influence of controlled biting activities. 9 This might be interpreted as a body sway stabilising effect. ...
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Background: The influence of the stomatognatic system on human posture control has been investigated under static conditions, but the effects on dynamic balance have not yet been considered. Objective: Investigating the influence of different functional stomatognatic activities (jaw clenching (JAW), tongue pressing (TON) and habitual jaw position (HAB)) on postural performance during a dynamic reactive balance task. Methods: Forty-eight physically active and healthy adults were assigned to three groups differing in oral motor tasks (JAW, TON or HAB). Dynamic reactive balance was assessed by an oscillating platform which was externally perturbed in four directions. Performance was quantified by means of Lehr's damping ratio. Mean speeds of the selected anatomical regions (head, trunk, pelvis, knee and foot) were analyzed to determine significant performance differences. Results: The groups differed significantly in balance performance in direction F (i.e. forwards acceleration of the platform). Post-hoc tests revealed that the JAW group had significantly better performance compared to both the HAB and TON groups. Better performance was associated with a decreased mean speed of the analyzed anatomical regions. Conclusion: JAW can improve dynamic reactive balance but the occurrence of positive effects seems to be task-specific and not general. TON seems not to have any observable effects on dynamic reactive balance performance, at least when evaluating it with an oscillating platform. JAW might be a valuable strategy which could possibly reduce the risk of falls in elderly people, however further investigations are still needed.
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In dental functional diagnostics, pathological changes in the entire jaw region can be detected using modern analytical methods and, thus, subsequently be treated in a targeted manner. This article aims to provide insight into the manifold connections between the oral cavity and the entire organism as well as treatment recommendations according to the current state of research. Behind almost every dental problem there is a functional connection, and this connection is conceivable in both directions: from the mouth to the body or from the body to the mouth. This is why function-oriented dentistry not only focuses on the teeth, but also provides the dentist with a holistic picture of disease by means of temporomandibular joint (TMJ) diagnostics and examination of surrounding structures. According to today’s knowledge and understanding, “occlusion” is associated with a more comprehensive concept than just the idealized idea of the arrangement and position of teeth and occlusal surfaces. Occlusion is an interface in the sense of dynamic biological relationships between the components of the masticatory system that cause or control tooth contacts under function and dysfunction. The functional mechanisms of different structures interlock like gears and are mutually dependent, in order to provide physiologically healthy form and function. Health problems caused by load-induced dysfunctions are not only related to the masticatory system, but also affect other parts of the body. As a consequence, for diagnosis as well as treatment, specialist experience, scientific exchange, and competent cooperation partners are absolutely necessary to take this complex interplay between the teeth, the masticatory musculature, the TMJ, and the neighboring structures into account as best as possible.
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Background/objectives The possible mechanisms supporting the relationship between the masticatory and the musculoskeletal systems have been recently investigated. It has been suggested that jaw clenching promotes ergogenic effects on prime movers through the phenomenon of concurrent activation potentiation (CAP). The purpose of this study was to analyze the effects of jaw clenching and jaw clenching while wearing MG on muscle activity and force output during three upper body isometric strength tests. Methods Twelve highly trained rink-hockey athletes were recruited for the study. A randomized, repeated measures within study design was carried out to compare the acute effects of three experimental conditions: jaw clenching while wearing MG (MG), jaw clenching without MG (JAW) and non-jaw clenching (NON-JAW). Results Statistical analyses revealed significant higher force output (p < 0.05) in all tests for MG conditions with respect to NON-JAW. When comparing JAW and NON-JAW conditions an increased peak force was found in handgrip (p = 0.045, d = 0.26) and bench press (p = 0.018, d = 0.43) but not in biceps curl (p = 0.562, d = 0.13). When comparing MG and JAW conditions, no differences were observed in any force output. In terms of muscle activity, significant differences were found in the agonist muscles of the handgrip test for MG with respect to NON-JAW (p = 0.031–0.046, d = 0.25–1.1). Conclusion This study demonstrated that jaw clenching, with and without MG, may be a good strategy to elicit the CAP phenomenon, which seems to promote ergogenic effects in upper body isometric force production. The non-significant differences observed between JAW and MG suggested that the use of MG doesn't make a difference in enhancing the isometric force production neither the muscle activity in upper body isometric strength.
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