Funktionelle Interdependenzen zwischen Kieferlage und motorischer Kontrolle von Haltung und Bewegung: Absteigende Funktionsketten

[Somatic dysfunction of the cervical spine and its complex clinical picture : The fundamentals of diagnostics of cervicobrachialgia and cervicocephalic syndrome through manual medicine]

Patients suffering from a segmental and somatic dysfunction of the cervical spine often present a wide variety of clinical symptoms related to cervicobrachial or cervicocephalic syndrome. These symptoms might evolve out of complex neural intersegmental or trigeminocervical interactions in the brain stem or the spinal cord of the cervical spine. After the exclusion of life-threatening preconditions, a careful physical examination with aspects of manual medicine aspects might unmask the cervical dysfunction as the primary cause of the symptoms. Treatment with manual medicine on the basis of a segmental antinociceptive proprioceptive input might then be an appropriate therapeutic approach.

Systematic changes of the static upper body posture with a symmetric occlusion condition

Background

Temporary occlusal changes and their influence on the upper body statics are still controversially discussed. Furthermore, concrete statements on whether age- or gender-specific differences in neurophysiological reactions exist are missing. Therefore, it is the aim of this study to evaluate the immediate effects of a symmetrical occlusion blocking on the upper body posture. These effects shall be investigated for both genders and for a larger age range.

Methods

In this study, 800 (407f/393 m) subjects volunteered aged from 21 to 60 years. Both genders were divided into four age groups according to decades. The three-dimensional upper body posture was measured by using the rasterstereography (ABW-Bodymapper). The habitual static posture was measured in two dental occlusion conditions (a) in rest position and (b) symmetrical blocking in the bicuspid region by cotton rolls.

Results

A significant reduction of the trunk length (0.72 mm; p <  0.001), an increase of the lumbar (0.30°; p <  0.001) and the thoracic bending angle (0.14°; p = 0.001), a reduction of the spinal forward decline (0.16°; p <  0.001) and a reduction of the scapular distance (0.36 mm; p = 0.001) was found. Gender-specific reactions can only be recorded in scapular distance, in that regard men reduce this distance while over all age groups women did not show a significant change.

Discussion

Slight gender- and age-independent reactions due to a symmetric occlusion blockade are shown: A gender independent reaction of the spinal related variables in the sagittal plane (thoracic and lumbar flexion angle, trunk length, spinal forward decline). In addition, a gender specific change of the shoulder blade distance could be observed, where men reduced the distance while female did not show a change. However, since these reactions are of a minimum amount, it can be concluded that neurophysiological compensation mechanisms work equally well regardless of age and sex, and the upper body posture of healthy people changes only very slightly due to a temporarily symmetrical altered bite position.