Do different dental conditions influence the static plantar pressure and stabilometry in young adults?

Influence of the mandibular position on various postural anatomical segments

OBJECTIVE

To determine postural changes in relation to mandibular position in maximum intercuspation and at rest in adult patients of both sexes.

METHODS

: A descriptive observational clinical study was carried out in 76 patients. Using an analyzer and the Meersseman test, the necessary dermal points for postural analysis were located.

RESULTS

: The authors found significant differences in the posture adopted by the patient between maximum intercuspation and mandibular rest in the frontal, sagittal, and dorsal planes. Foot support in the right foot went from cavus to normal in 6% of the sample, and from flat to normal in 2.5% of the sample in the jaw rest position.

CONCLUSION

Postural changes were observed in various segments, with clinical and statistical significance at cervical level in the frontal plane, in the biscapular variable in the dorsal plane, and at the level of the lower limbs in the bipopliteal and bimalleolar variables.

Impact of occlusal proprioception on static postural balance

Conflicting results on the effects of occlusal proprioceptive information on standing sway have been reported in the literature, partly due to the heterogeneity of the occlusal criterion studied and the experimental protocol used. In this study, occlusal functions, different mandibular positions and visual conditions were used to investigate the involvement of occlusal proprioception information in static postural balance. Postural adjustments of 26 healthy young adults, divided into Class I malocclusion and Class I normocclusion groups, were studied in upright position, in five mandibular positions (1 free, 2 centric and 2 eccentric), with and without vision. Due to different reported test durations, postural parameters were examined for the first and last halves of the 51.2 s acquisition time. A permutation ANOVA with 4 factors was used: group, mandibular position, vision, time window. Mean length of CoP displacement was shorter with vision (ES = 0.30) and more affected by vision loss in the free than in the intercuspal mandibular position (ES = 0.76 vs. 0.39), which has more tooth contacts. The malocclusion group was more affected by vision loss (ES = 0.64). Unexpectedly, with vision, the mean length was smaller in one eccentric occlusion side compared to the other (ES = 0.51), but independent of the left or right side, and more affected by vision loss (ES = 1.04 vs. ES = 0.71). The first-time window of the acquisition time, i.e. 25.6 s, was sufficient to demonstrate the impact of dental occlusion, except for the sway area. Comparison of the two visual conditions was informative. With vision, the weight of occlusal proprioception was not strictly related to occlusal characteristics (number of teeth in contact; centered or eccentric mandibular position), and it was asymmetrical. Without vision, the lack of difference between groups and mandibular positions suggested a sensory reweighting, probably to limit postural disturbance.

Methods of postural analysis in connection with the stomatognathic system. A systematic review

This systematic review aimed to identify the main tools used to analyze the relationship between the postural and stomatognathic systems. The study followed the PRISMA guidelines, and data were collected from Science Direct and PubMed databases to identify articles published until December 2022. After applying inclusion and exclusion criteria, 26 articles were selected from the initial 903 articles. The selected articles were full-text studies in English or Romanian, examining the relationship between dental occlusion and posture, measuring postural parameters using various tools, implementing occlusal changes, evaluating patients with permanent dentition, or analyzing the connection between occlusion and posture in a unidirectional manner. The findings indicate that orthognathic surgery and orthodontic mouthguards can significantly enhance postural balance and athletic performance. In addition, 63% of the studies concluded that varying modifications and occlusal conditions impact posture. Notable differences exist concerning posture and Angle dental occlusion classes, and different occlusal devices used to simulate malocclusion can affect patients' postural systems in response to external stimuli. The stabilometry platform is the predominant method for measuring postural parameters; however, other researchers have employed raster stereography, photogrammetry, mobile phone apps, and the Fukuda-Unterberger test. Consequently, interventions targeting the stomatognathic system should consider potential variations in the postural system.

Is There a Correlation between Dental Occlusion, Postural Stability and Selected Gait Parameters in Adults?

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.

Influence of occlusion and mandibular position on foot support and head posture in adult patients

OBJECTIVE

To study postural changes, taking into account different mandibular positions and the cephalic and plantar body segments.

METHODS

A cross-sectional, descriptive, clinical, and observational study was carried out on 76 patients, (mean age 28.79 years), in whom body posture and plantar support were evaluated in the maximum mandibular intercuspal position and the mandibular rest position without dental contact.

RESULTS

When the mandibular position was altered, 71.01% of the patients showed changes in the bipupillary line (p = 0.008), while those who did not show such changes did, however, show changes in plantar support. More than 85% of the sample experienced alterations in the plantar plane when the mandibular position was changed, with statistically significant results (p < 0.001).

CONCLUSION

There is a positive relationship between the different segments in body posture. In the sample, changes in plantar support with respect to the different mandibular positions were noticeable.

Postural Balance in Relation with Vision and Physical Activity in Healthy Young Adults

Postural balance is an essential part of a wide range of activities, from daily living tasks to sports. Regularly repeated physical and/or sport activities improve both the postural performance and the postural strategy. The aim of our study was to evaluate if the physical activity level is a factor that influences postural balance performance, including the impact of vision and gender, in healthy young adults. Postural balance was assessed in 78 subjects (38 males and 40 females, aged 20.64 ± 1.18 years) by using the PoData system, in open (EO) and closed (EC) eye conditions. Based on the physical activity level, subjects were classified in two groups—low physical activity level (n = 36, 46.15%) and moderate physical activity level (n = 42, 53.85%). A group significant difference was found only for the average centre of pressure (CoP) deviations on the latero-lateral axis (CoP_X), with a higher lateral deviation of the CoP (toward right) in the low physical activity group (F = 4.005, p = 0.04). CoP path length, the 90% confidence ellipse and maximum CoP speed were significantly increased in EC conditions. A statistically significant interaction effect (vision × physical activity) was observed for the CoP path length (F = 7.9, p = 0.006).

The Refraction Assessment and the Electronic Trial Frame Measurement during Standing or Sitting Position Can Affect Postural Stability

Vision has been shown to influence body posture. The purpose of this study is to investigate the correlations between visual acuity and body postural control both in a standing and seated position. This cohort study included 37 patients examined using Adaptica’s (Italy) Kaleidos and VisionFit. Objective refraction was measured with Kaleidos both in a standing and seated position by the same operator and in the same environmental conditions. The parameters obtained with the device were binocular refraction, monocular refraction, pupil distance, pupil size, head tilt, gaze, phorias, and tropias. The results obtained were then subjectively tested using VisionFit: an electronic trial frame with phoropter functionalities. The study’s outcome revealed that the differences in the visual acuity parameters obtained in standing and seated positions were statistically significant; the Student’s t-test showed a p-value < 0.001 in all parameter averages. Automated refraction is widely being performed and postural control can affect the visual acuity parameters; therefore, it is relevant to consider the possibility of measuring in orthostatism. It might be appropriate to take into account the possibility of measuring in orthostatism and wearing trial frames in orthostatic conditions as well as walking freely around the room, looking outside of a window, sitting, and reading.

INVESTIGATION OF PLANTAR PRESSURE AND PLANTAR IMBALANCES IN THE STATIC PHASE OF KARATE DO ATHLETES

The study aims to investigate the parameters offered by the baropodometric examination on a group of athletes practicing the martial art Karate Do (20 subjects, 16 girls and 4 boys, average age 13.55 ± 2.74, height 163 cm ± 8.47 , weight 54.50 kg ± 8.84, BMI (body index mass) of 20.46 ± 2.90 and seniority in sports activity of 5.27 years ± 2.74). The purpose of the research is to determine the changes related to the value of the plantar surfaces, the pressures for the dominant and non-dominant lower segments, the positioning of the pressure center in relation to the support polygon and the imbalances in the sole of the foot. The testing was performed using the FreeMed baropodometric platform and the FreeStep by Sensor Medica software, in the last week of February 2021, at the Research Center for Human Performance within the Faculty of Physical Education and Sports, “Dunărea de Jos” University from Galați. Results: Placing the maximum pressure point / P.max in the forefoot area is an exception, only one case being reported with this distribution, the rest having P.max located at the rearfoot level. Comparison of the averages between the variables recorded for the left foot vs. the right foot highlights higher values of the dominant / right foot, but these differences are significant only for the values of the plantar pressure in the forefoot area and for the total load on the entire plantar surface / total load (p <.05). The comparison between the averages of the surfaces and the loads of each separate foot (for the forefoot and rearfoot areas) highlights major differences only for the values of the contact surfaces, the forefoot area being significantly larger than the rearfoot area (p <.05). Close average values with small and insignificant differences are reported for each foot between the forefoot and rearfoot areas when comparing the body pressure / load percent and weight ratio percent, indicating a balanced pressure distribution between the front and back area for each leg. The investigation was also useful by detecting the existing imbalances at the plantar level, for one or both legs, being also reported cases of hollow, flat and mixed foot. These plantar disturbances can negatively affect all the overlying / upper joints, but especially the body posture, thus being able to cause pain in the lumbar region, limiting the performance activity and causing even the withdrawal of the athletes. We recommend that after identifying the syndromes at the ankle joint, to implement personalized plantar supports, which should be introduced in sports shoes in order to balance the architecture of the foot sole. Keywords: karate do, plantar pressures, baropodometric analysis, load, rearfoot, forefoot, maximum pressure,

Plantar Pressure Variations Induced by Experimental Malocclusion-A Pilot Case Series Study

Background: All body systems involved in ensuring a healthy posture (musculoskeletal system, oculomotor, oto-vestibular and occluso-cranial-mandibular) are essential in maintaining postural balance. Research Question: Does experimental malocclusion in subjects in static position determine variations in plantar pressure? Methods: Overall, 31 subjects were included in the study. The plantar pressure was evaluated in five different points: lateral and medial heel, midfoot, 1st and 5th metatarsal area. Using a specially designed splint, an artificial malocclusion was induced on the right hemimandibular arch. The pressure was measured at 0 (T0), 15 (T1) and 30 min (T2) after splint application. Results: The right external plantar sensors recorded statistically significant differences in pressure values after 15 min of splint wear (5th metatarsal area, p = 0.05; midfoot, p = 0.04). Important pressure values were also recorded by the left internal plantar sensors (1st metatarsal, p = 0.01; medial heel, p = 0.006), after 30 min of splint wear. Conclusions: Asymmetrical experimental malocclusion produces early changes in plantar pressure, a proof of compensatory mechanisms induced by secondary postural imbalance.

Symmetrical dental occlusion blocking - changes of body sway and weight distribution in healthy subjects across 4 age decades

Objectives

Symmetrical dental occlusion blocking is used in dentistry as a quick diagnostic tool to test for potential influences of the craniomandibular system on body sway and weight distribution. This study presents the changes of body sway and pressure distribution in healthy subjects, free of a temporomandibular dysfunction (TMD). Immediate effects between occlusal blocking and rest position on body sway and body weight distribution in general, as well as for both genders and for four age decades will be evaluated.

Materials and methods

725 (396f/329 m) subjects (neither subjective signs of TMD nor acute/chronic complaints in the musculoskeletal system) volunteered (21 to 60 years) while both genders were divided into four age groups according to decades. A pressure measuring platform was used. Body sway and weight distribution were recorded in two dental occlusion conditions (a) in rest position and (b) symmetrical blocking (bicuspid region) by cotton rolls.

Results

Both, the frontal sway and the sagittal sway reduced by 0.67 mm (t(724) = − 3.9 (p <  0.001)) and by 0.33 mm (t(724) = − 3.4 (p <  0.001)). The relative pressure under the left forefoot increased by 0.33% (t(724) = 2.88 (p <  0.001)) and the relative pressure overall under the forefoot increased by 0.67% (t(724) = − 3.4 (p <  0.001)). Gender-specific, age-specific and BMI-specific reactions could not be identified.

Conclusions

Subjects, free of any TMD and with no complaints of the musculoskeletal system, show small changes of the body sway and weight distribution when biting symmetrically on a cotton roll. These changes are independent of age, gender or body mass index (BMI). Due to the relative large sample size, the presented results can also be seen as norm values when body sway is used as an additional assessment of a TMD.