Einfluss von Zahnveränderungen auf die Körperhaltung: Effekt der Orientierung im äußeren Raum

Association between constitution, axiography, orthodontic cast analysis, and upper body posture in women aged 31 to 40 years

OBJECTIVE

Whether it is primarily the spine that reacts with pain to the negative consequences of everyday stress and possibly the temporomandibular system as a result (ascending chain), or whether incorrect stress in the dental area has an influence on body geometry (descending chain), is still a controversially discussed topic. The aim of this study is to investigate possible relationships between constitutional, axiographic, and dental parameters with upper body posture.

MATERIAL AND METHODS

A total of 106 subjectively healthy women between 31 and 40 years of age voluntarily participated in this study. Data collection was done by filling out a questionnaire with constitutional and anamnestic parameters and by evaluating orthodontic casts, axiographic measurements, and video raster stereographic measurements. These data were analyzed using correlations and group comparisons, with the significance level set at p ≤ 0.05.

RESULTS

Positive correlations were shown between the constitutional factors of body weight and BMI and the lumbar bending angle (p = 0.01), the kyphosis angle (p = 0.001), and lordosis angle (weight p = 0.05; BMI p = 0.03). In the cast analysis, regardless of the direction of the midline shift (left/right/none), a left lateral tilt can be seen which is greatest at 2.12° with a left midline shift. In addition, the elevated pelvic side correlates with the side of the displacement of the jaw, with the stronger manifestation being on the left side. With a vertical anterior bite in the normal range, the kyphosis angle is 48.09°, while with a deep bite, it is 60.92°, and with an open bite, it is 62.47°; thus, the group in the normal range differs significantly (p = 0.01) from the other two. The greater the protrusion, the smaller the sagittal plane angles (kyphosis angle, lumbar bending angle, each p = 0.03), and the more dorsal the posture (p = 0.04). The lordosis angle differs significantly (p = 0.001) between the group of subjects with a protrusion in the normal range (52.34°) and the group with an increased advancement of the mandible (41.79°).

CONCLUSION

There is a correlation between body weight, BMI, midline shift, and protrusion, as well as the vertical anterior step and upper body posture in women between 31 and 40 years of age. Interdisciplinary functional examinations of the temporomandibular musculature, and also sustained orthodontic treatment, can contribute to an improvement in upper body posture.

Baseline of upper teeth: (a) Control organ for spatial navigation? (b) Weak point for misaligned posture and pain?

Our observations question both the current doctrine of spatial orientation as processed by vestibular, visual and proprioceptive impressions as well as the horizontal alignment of the eye axis. Indeed our observations suggest spatial orientation as a physically based, largely mechanically transmitted interaction between individual and environment. It is controlled by an interface defined by the baseline of upper teeth. It simultaneously constitutes both body and environment acting as an integral part of that environment. Consequently, the baseline of upper teeth is part of the aforementioned environment. Instead of the eye axis during spatial orientation it aligns the true horizontal absolutely. This was tested by fixing a cross to upper teeth. While walking, running and jumping it did not deviate by more than 2° from the external axis. Subsequently, we inclined the baseline of upper teeth by inserting an asymmetric wafer so that it angulated the eye axis. Immediately, head, visual and vestibular axes tilted unstably with misaligned body posture. Only the indicative cross remained stably aligned to the external axes. The person felt "upright", not noticing his posture had changed. He was then instructed to straighten his shoulders and trunk until his posture was objectively nearly upright again. The voluntary correction caused the indicative cross to tilt. The person felt uneven while being more upright. We concluded that the automatic posture works by "synchronizing" the baseline of upper teeth to the external axis and that the synchronized position is supported by the vestibular system. Benefit of an interface is that the body's movements in the environment simultaneously happen within the baseline of upper teeth. Therein the vectors of the body and the environment are calculated to remain in balance. This model introduces the transmission of the vector information to postural muscles by the dura mater, controlled by tension between C0-C2. The information is skewed by bony dislocations between C0-C2 caused by an inclination of the interface. The resulting misalignments of posture are foreseeable and specifically correspond to the type of inclination. They occur in a broad section of the population. Diagnosed as muscular weakness, they may cause therapy resistant common diseases like back and joint pain after 5-10 years. Following our observations, the inclination of the baseline of upper teeth originates from inattentive changes in the length of upper teeth in dental treatment. Multiple treatments optimizing teeth length in long term patients improved the patients' situation.