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Difference between revisions of "Occlusion and Posture"
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VEMPs, translated into Myogenic Vestibular Evoked Potentials are proof of this. Acoustic stimuli can evoke EMG reflex responses in the masseter muscle called Vestibular Evoked Myogenic Potentials (VEMPs). Although these findings have previously been attributed to activation of cochlear (high-intensity sound) receptors, these may also activate vestibular receptors. Because anatomical and physiological studies in both animals and humans have demonstrated that the masseter muscles are a target for vestibular inputs, the authors of this study reevaluated the vestibular contribution for masseter reflexes. This is a typical example of a basic level 'Complex System' as it consists of only two cranial nervous systems but, at the same time, they interact by activating monosynaptic and polysynaptic circuits (Figure 1).</blockquote> | VEMPs, translated into Myogenic Vestibular Evoked Potentials are proof of this. Acoustic stimuli can evoke EMG reflex responses in the masseter muscle called Vestibular Evoked Myogenic Potentials (VEMPs). Although these findings have previously been attributed to activation of cochlear (high-intensity sound) receptors, these may also activate vestibular receptors. Because anatomical and physiological studies in both animals and humans have demonstrated that the masseter muscles are a target for vestibular inputs, the authors of this study reevaluated the vestibular contribution for masseter reflexes. This is a typical example of a basic level 'Complex System' as it consists of only two cranial nervous systems but, at the same time, they interact by activating monosynaptic and polysynaptic circuits (Figure 1).</blockquote> | ||
==== Tmj disorders and posture ==== | |||
It has been shown that changes in the temporomandibular joint (TMJ) can have a direct impact on muscle activity in terms of posture, stability and physical performance.<ref name=":2" /><ref>Moon H.J., Lee Y.K. The relationship between dental occlusion/temporomandibular joint status and general body health: Part 1. Dental occlusion and TMJ status exert an influence on general body health. J. Altern. Complement. Med. 2011;17:[tel:995–1000 995–1000]. doi: 10.1089/acm.2010.0739.</ref><ref>Souza J.A., Pasinato F., Correa E.A., da Silva A.M. Global body posture and plantar pressure distribution in individuals with and without temporomandibular disorder: A preliminary study. J. Manip. Physiol. Ther. 2014;37:407–414.</ref> However, there is a lack of high-quality studies using advanced measurement tools to better understand the phenomenon under investigation.<ref>Ferrillo M., Marotta N., Giudice A., Calafiore D., Curci C., Fortunato L., Ammendolia A., de Sire A. Effects of occlusal splints on spinal posture in patients with temporomandibular disorders: A systematic review. Healthcare. 2022;10:739. doi: 10.3390/healthcare10040739.</ref> The study authors evaluated the impact of masticatory abnormalities on postural control and focuses on evaluating individuals with specific malocclusions that determine the anteroposterior position of the mandible. According to some researchers, malocclusion, like TMD, can affect the osteoarticular system of the whole body and become a source of persistent pain and favor the development and to become chronic of some postural defects. According to the cited authors, occlusal disturbances can lead to an altered stimulation of the periodontal proprioceptors, causing changes in the tension of the neck muscles and postural muscles and changes in the position of the head, followed by compensatory changes in the anatomical regions in their immediate vicinity. Over time, this can affect the posture, center of gravity position, or foot contact with the ground.<ref name=":0" /><ref name=":11" /><ref name=":12" /><ref>Saccucci M., Tettamanti L., Mummolo S., Polimeni A., Festa F., Tecco S. Scoliosis and dental occlusion: A review of the literature. Scoliosis. 2011;6:1–15. doi: 10.1186/1748-7161-6-15. </ref><ref>Sforza C., Tartaglia G.M., Solimene U., Morgan V., Kaspranskiy R.R., Ferrario V.F. Occlusion, sternocleidomastoid muscle activity, and body sway: A pilot study in male astronauts. Cranio. 2006;24:43–49. doi: 10.1179/crn.2006.008</ref> | |||
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==== Bruxism and Posture ==== | |||
Angle suggested a classification of occlusion and malocclusion based on the anteroposterior position of the first molar and the position of the canines.<ref>Bernabé E., Sheiham A., de Oliveira C.M. Condition-specific impacts on quality of life attributed to malocclusion by adolescents with normal occlusion and Class I, II and III malocclusion. Angle Orthod. 2008;78:977–982. doi: 10.2319/091707-444.1</ref><ref name=":13">Okeson J.P. Management of Temporomandibular Disorders and Occlusion.Mosby; Maryland Heights, MO, USA: 2019.</ref>Malocclusion is often a congenital condition, resulting from hereditary or environmental factors. It is also caused by local factors, such as an abnormal pattern of breathing or postural defects, as well as oral parafunctions such as nail biting or teeth grinding (bruxism).<ref name=":13" />According to Lombardo's analyses, occlusal anomalies occur on average in 56% of the general population.<ref name=":14">Lombardo G., Vena F., Negr P., Pagano S., Barilotti C., Paglia L., Colombo S., Orso M., Cianetti S. Worldwide prevalence of malocclusion in the different stages of dentition: A systematic review and meta-analysis. Eur. J. Paediatr. Dent. 2020;21:115–122.</ref> Their prevalence increases with age. Given their increasing prevalence in later age groups and the consequences they entail, it is reasonable to expect a large number of adult patients who will require complex and expensive multidisciplinary treatment.<ref name=":14" /><ref>Kawala B., Szumielewicz M., Kozanecka A. Are orthodontists still needed? Epidemiology of malocclusion among polish children and teenagers in last 15 years. Dent. Med. Probl. 2009;46:273–278</ref> | Angle suggested a classification of occlusion and malocclusion based on the anteroposterior position of the first molar and the position of the canines.<ref>Bernabé E., Sheiham A., de Oliveira C.M. Condition-specific impacts on quality of life attributed to malocclusion by adolescents with normal occlusion and Class I, II and III malocclusion. Angle Orthod. 2008;78:977–982. doi: 10.2319/091707-444.1</ref><ref name=":13">Okeson J.P. Management of Temporomandibular Disorders and Occlusion.Mosby; Maryland Heights, MO, USA: 2019.</ref>Malocclusion is often a congenital condition, resulting from hereditary or environmental factors. It is also caused by local factors, such as an abnormal pattern of breathing or postural defects, as well as oral parafunctions such as nail biting or teeth grinding (bruxism).<ref name=":13" />According to Lombardo's analyses, occlusal anomalies occur on average in 56% of the general population.<ref name=":14">Lombardo G., Vena F., Negr P., Pagano S., Barilotti C., Paglia L., Colombo S., Orso M., Cianetti S. Worldwide prevalence of malocclusion in the different stages of dentition: A systematic review and meta-analysis. Eur. J. Paediatr. Dent. 2020;21:115–122.</ref> Their prevalence increases with age. Given their increasing prevalence in later age groups and the consequences they entail, it is reasonable to expect a large number of adult patients who will require complex and expensive multidisciplinary treatment.<ref name=":14" /><ref>Kawala B., Szumielewicz M., Kozanecka A. Are orthodontists still needed? Epidemiology of malocclusion among polish children and teenagers in last 15 years. Dent. Med. Probl. 2009;46:273–278</ref> | ||
<blockquote>[[File:Question 2.jpg|left|50x50px]]Regarding bruxism<ref name=":13" /> we certainly cannot speak of scientific certainties or take into consideration the incidence of bruxism in the population because, as described in the specific chapter concerning our patient '[[Encrypted code: Hyperexcitability of the trigeminal system|Bruxer]]', he had a perfect occlusion and neuromuscular responses apparently up to standard if it hadn't been for the study of the case and have highlighted a neuronal hyperexcitability with the test of the | <blockquote>[[File:Question 2.jpg|left|50x50px]]Regarding bruxism<ref name=":13" /> we certainly cannot speak of scientific certainties or take into consideration the incidence of bruxism in the population because, as described in the specific chapter concerning our patient '[[Encrypted code: Hyperexcitability of the trigeminal system|Bruxer]]', he had a perfect occlusion and neuromuscular responses apparently up to standard if it hadn't been for the study of the case and have highlighted a neuronal hyperexcitability with the test of the <sub>rc</sub>MIR masseter inhibitory recovery cycle (Figure 3). | ||
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[[File:Recovery cycle.jpeg|500x500px|Figura 3: <sub>rc</sub>MIR in paziente bruxista|center]]'''Figura 3:''' <sub>rc</sub>MIR in brusiste patient | [[File:Recovery cycle.jpeg|500x500px|Figura 3: <sub>rc</sub>MIR in paziente bruxista|center]]'''Figura 3:''' <sub>rc</sub>MIR in brusiste patient | ||
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Although the patient was in a state of neuronal hyperexcitability which affected the entire left leg with stiffness of the upper limbs, he never accused | Although the patient was in a state of neuronal hyperexcitability which affected the entire left leg with stiffness of the upper limbs, he never accused postural problems. With this we want to underline that although there are correlations between different cerebral association areas such as the vestibular, the trigeminal, the midbrain and so on, this does not give the clinician the right to base the diagnosis on these certainties. As, of course, we will repeat repeatedly throughout the 'Normal Science' section to justify the next section which will focus on the aspect of the anomalies and therefore the crisis of the paradigm.</blockquote> | ||
There is still a lack of research on the effect of occlusion on postural stability and plantar pressure distribution during standing and walking in the same group of adults with Angle Class I, II, and III. | Given the high proportion of patients with malocclusions <ref name=":5" /><ref name=":6" /> and the conflicting reports of these reports, <ref name=":1" /><ref name=":2" /><ref name=":3" /><ref name=":4" /><ref name=":5" /><ref name=":6" /><ref name=":7" /><ref name=":8" /><ref name=":9" /><ref name=":10" /> the need for further knowledge and analysis of individual malocclusions and associated musculoskeletal abnormalities under dynamic and static conditions is reasonable. There is still a lack of research on the effect of occlusion on postural stability and plantar pressure distribution during standing and walking in the same group of adults with Angle Class I, II, and III. | ||
====Contents to refute the correlation==== | ====Contents to refute the correlation==== | ||