Increase of the vertical occlusal dimension by means of a removable orthodontic appliance and its effect on craniocervical relationships and position of the cervical spine in children

Evaluation of head and cervical spine posture after functional therapy with Twin‑Block and Bionator appliances: A pilot randomized controlled trial

OBJECTIVE

Evaluation of head and cervical spine posture and estimation of sample size.

METHODS

Thirty eligible participants who required functional therapy were randomly assigned to the Control group (C), Twin Block group (TB), or the Bionator group (B). Randomization was accomplished by means of blocks of fixed size stratified by sex and age, with the allocations concealed in opaque and sealed envelopes.

RESULTS

Significant differences were identified between the pre -and post-functional SNB (p = 0.024) and ANB (p = 0.034) angles in the Twin Block group and SNA (p = 0. 019) and ANB (p = 0. 028) angles in the Bionator group. No statistically significant changes were seen in the head or cervical variables in the three groups.

CONCLUSION

The functional appliance did not cause any statistical change in head posture or cervical spinal column in comparison with the non-treatment group.

Three-dimensional evaluation of the effects of Bionator and Forsus appliances on oropharyngeal airway volume in patients with mandibular retrognathia

OBJECTIVE

To evaluate whether there is a difference between the effects of Bionator and Forsus appliances on airway volume.

METHODS

Forty patients with mandibular retrognathia were divided into two groups. The Bionator appliance was applied to Group 1, while the Forsus FRD EZ2 appliance was applied to Group 2. Three-dimensional images were captured before and after functional appliance use in both groups. Dolphin 3D software was used for airway measurements.

RESULTS

No statistically significant difference was found between the groups in terms of volumetric and area measurements. There was a statistically significant difference between the minimum axial T and O-N border T measurements of the groups.

CONCLUSION

The use of functional appliances may contribute to an increase in oropharyngeal airway dimensions, but there was no difference between the Bionator and Forsus groups in terms of volumetric measurements.

Craniovertebral and Craniomandibular Changes in Patients with Temporomandibular Joint Disorders after Physiotherapy Combined with Occlusal Splint Therapy: A Prospective Case Control Study

Background and Objectives: The aim of the study was to assess the craniovertebral and craniomandibular changes in patients diagnosed with temporomandibular joint disorders (TMD) after physiotherapy combined with occlusal splint therapy. Materials and Methods: There were forty patients (32 females, 80%), diagnosed with TMD, included into the study group. After the initial series of physiotherapy, patients received maxillary occlusal splints to be worn day and night. Participants continued physiotherapy simultaneously with occlusal splint therapy for 6 months. Lateral cephalograms taken in natural head position before and after the end of the therapy were used for measurements. The control group consisted of 15 healthy participants (12 females, 80%), who had taken lateral cephalograms twice, and did not receive any type of occlusal treatment nor physiotherapy in the meantime. Results: Occlusal splint therapy and physiotherapy combined together significantly affected: the vertical position of the mandible (significant increase, p < 0.0001), the sagittal position of mandible (significant decrease, p = 0.0065), as well as the width of the functional space between C1 and C2 (significant decrease, p = 0.0042). Moreover, the cervical lordosis was restored after the end of the treatment (p < 0.0001). Conclusions: Cooperation of physiotherapists with dental practitioners is necessary in the treatment of patients with TMD, including temporomandibular joint osteoarthritis.

Effects of Induced Malocclusion on Vertebral Alignment in Rats: A Controlled Study by CBCTs

Simple Summary

Nowadays, there is insufficient available evidence to validate a correlation between dental occlusion disorders and spinal curvature, and therefore, more studies are necessary to clarify how and to what extent the modifications of the occlusion might affect vertebral spine biomechanics. The following paper is a controlled study on rats that aims to induce a malocclusion in rats’ mouths by a bite-raising on the upper molars and then to check the alteration of vertebral alignment over time by a CBCT analysis. Alteration of vertebral alignment in rats with induced malocclusion could support the hypothesis of a correlation between occlusal contact and body posture and open the way for further studies on mandibular repositioning and posture control in humans.

Abstract

This study aimed to evaluate with CBCTs the alteration of vertebral alignment over time of induced malocclusion in rats. Crown pads increasing the vertical dimension of 0.5 mm were applied on the upper molars at one randomly selected side of the maxilla in rats (premature contact side) while the opposite side was left untreated (control side). Four groups were organized, ten animals each. In groups A, B, and C, the crowns were applied at time 0 (t-0). In group A, the crowns were removed after 2 weeks (t-2w) and euthanized after two more weeks, while in groups B and C, the animals were euthanized after 2 and 4 weeks (t-4w), respectively. No premature contacts were applied in group D. CBCTs were taken at t-0 in all animals before applying the crowns, at t-2w in group A before removing the crowns, and in all groups before the euthanasia. The changes in the iliac crest angle (ICA) that formed between the superior external margin of the iliac crest and the vertebral spine were evaluated. In groups A and B, after 2 weeks, the changes in ICA were statistically significant at p = 0.028 and p = 0.042, respectively. In group C, and in the control group D, the changes of ICA were not statistically significant (p = 0.058 and p = 0.414, respectively). In conclusion, the incease in monolateral occlusion in the molar region yielded a rotation of the lumbo-sacral segment towards the same side of the occlusal bite-raising.

Effect of facial massage on static balance in individuals with temporomandibular disorder - a pilot study

Introduction

The influence of the neuromuscular system on the cervical region and mastication is directly associated with mandibular movements and neck posture. Normal occlusal homeostasis depends on complex sensory feedback mechanisms of the periodontal ligament, temporomandibular joint and other structures of the stomatognathic system. This feedback serves as a regulatory mechanism that helps determine the force and nature of muscle contractions. Alterations in the muscles of mastication, neck muscles, and occlusal characteristics constitute causal factors of imbalances in the postural muscle chains, leading to alterations in the center of pressure (CoP) of the feet. Thus, therapies that seek occlusal reestablishment, such as muscle relaxation techniques, may lead to a restructuring of the global equilibrium of the neuromuscular system and an improvement in body posture.

Purpose

The aim of the present pilot study was to investigate the immediate effect of facial massage on the CoP in the anteroposterior (CoP_AP) and mediolateral (CoP_ML) directions in individuals with temporomandibular disorder (TMD).

Methods

Twenty individuals with a diagnosis of TMD based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were submitted to a facial massage technique. CoP_AP and CoP_ML were evaluated using a force plate. Evaluations were performed under two visual conditions (eyes open and eyes closed) prior to resting in dorsal decubitus (baseline), after 10 minutes of rest (premassage) and after the administration of the massage technique (postmassage).

Results

No significant differences were found regarding CoP_AP velocity with eyes open or the following aspects under either visual condition (eyes open or closed): CoP_ML velocity, RMS of CoP_AP, RMS of CoP_ML, and sway area. The only significant difference was found for mean CoP_AP velocity with eyes closed.

Conclusions

While the results of the present study demonstrate the reliability of the reproduction of the data, facial massage had no immediate influence on postural control in individuals with TMD.