Influence of Dental Malocclusion on Body Posture and Foot Posture in Children: A Cross-Sectional Study

Assessment of the Relationship between Antero-Posterior Dental Malocclusions, Body Posture Abnormalities and Selected Static Foot Parameters in Adults

Objectives: This study aimed to find if a relationship exists between antero-posterior malocclusions and the level of musculoskeletal disorders in adults, including body posture and static foot analysis. Methods: In all, 420 participants were recruited through convenience sampling (Kraków University students and patients of a local dentist's practice). Following general medical interviews, dental examinations and consideration of inclusion and exclusion criteria, 90 healthy volunteers (ages 19-35) were enrolled and assigned to three groups (n = 30) based on occlusion type (Angle's molar Class I, II or III). The research procedure involved occlusion and temporomandibular disorder assessment conducted by a dental specialist. Comprehensive morphological measurements of body asymmetry were performed using the Videography 2D package and FreeSTEP software, which calculated the parameters determined from anterior, posterior and lateral projection photos. Foot loading distribution was analyzed using the FreeMED baropodometric platform. Results: Significant differences were demonstrated in the positioning of the head, cervical and lumbar spine in the sagittal plane among individuals with the analyzed occlusal classes (p < 0.05). Individuals with Angle's Class II exhibited significantly greater forward head positions and greater depths of cervical and lumbar lordosis compared with individuals with Class III or Class I. Those with overbites had higher forefoot loading. The Class III individuals exhibited greater L-R displacement, indicating a larger angle of displacement of the centers of the right and left feet relative to the lower edge of the measurement platform, suggesting pelvic rotation. Conclusions: An inclination for concurrent occurrences of malocclusions and posture deviations in the sagittal plane was observed. An interdisciplinary approach involving dentistry and physiotherapy specialists which utilizes tools for comprehensive posture assessment is crucial for diagnosing and treating such conditions.

The Correlation between Malocclusion and Body Posture and Cervical Vertebral, Podal System, and Gait Parameters in Children: A Systematic Review

Background: This study investigates the relationship between malocclusion and body posture, head posture, podal system, and gait parameters in children. Methods: A systematic review of observational studies from 2010 to 2023 was conducted and 24 cross-sectional studies involving 6199 participants were identified. These studies were categorized into those dealing with body posture (10 studies, 3601 participants), cervical vertebral column and head posture (6 studies, 644 participants), the podal system (5 studies, 1118 participants), and gait (3 studies, 836 participants). Results: Evidence suggests a significant association between malocclusion and body posture, balance, podal system, and gait parameters. Notably, eight studies found a significant relationship between malocclusion and body posture, while five studies identified this relationship with the cervical vertebral column and head posture, five with the podal system, and three with gait parameters. Conclusions: Overall, the quality of evidence was strong for the association between malocclusion and body posture and the podal system and moderate for head posture and gait parameters. These findings offer insights for therapists to design interventions tailored to children with malocclusion based on considerations of body posture, head posture, podal system, and gait parameters, though further longitudinal cohort studies are needed for better predictive understanding.

Malocclusion and Scoliosis: Is There a Correlation?

INTRODUCTION

Scoliosis is a complex three-dimensional malformation of the spine. Although its etiology is still being investigated, it is clear that a number of factors can influence this syndrome. The spinal deformity of idiopathic scoliosis can be viewed from an etiopathogenetic perspective as a symptom of a complicated condition with a multifactorial etiology. Numerous studies have established its relationship with malocclusion, but it is still unclear how these factors interact. Malocclusion is a change in the physiological alignment of the upper and lower teeth that can be either dental or skeletal in origin. This study's objective is to assess the relationship between scoliosis and malocclusion.

MATERIAL AND METHODS

A total of 646 patients were enrolled (554 females and 92 males), 447 with scoliosis and 199 without, from private dental and orthopedic practices, to answer an anonymous questionnaire. They were selected in private dental and orthopedic practices where they had dental and orthopedic examinations. Twenty-two patients were excluded because of a lack of answers. Participants were given a bilingual survey, in English and Italian, composed of 13 questions formulated specifically for this study, using Google Forms (Google LLC, Mountain View, CA, USA).

RESULTS

Univariate analysis of the question "Do you have scoliosis?" shows a significant correlation with the following questions: "Was scoliosis a family issue?" (p < 0.05 OR 7.30 IC: 3.05-17.46) "Do you have malocclusion?" (p < 0.05, OR: 1.19 IC:1.0-1.34) and "Was mal-occlusion a family issue?" (p < 0.01, OR: 1.39 IC 1.10-1.77). Performing a multivariate analysis for the same variables, the best predictors of scoliosis were "Was scoliosis a family issue?" (p < 0.001) and "Was malocclusion a family issue?" (p < 0.05), while the question "Do you have malocclusion" lost significance.

CONCLUSION

This study adds further confirmation that there might be an important connection between malocclusion and scoliosis; it suggests that dentists and orthopedists have to check, as early as possible, for the probable presence of both pathologies to avoid a severe progression which, in most cases, may require significant therapy and even surgery.

Dental Malocclusion in Mixed Dentition Children and Its Relation to Podal System and Gait Parameters

BACKGROUND

Dental malocclusion is an increasingly frequent stomatognathic disorder in children and adolescents nowadays. The purpose of this study was to confirm or deny the correlations between body posture and malocclusion.

METHODS

In the study, gait, distribution of foot pressure on the ground, and body balance were examined. The research group consisted of 76 patients aged 12-15 years. The research group was obtained from patients attending periodic dental check-ups at Healthcare Center Your Health EL who agreed to participate in the study. The patients were divided into two groups without malocclusion and with malocclusion, using Angle classification, which enabled determination of the anteroposterior relationship of the first molars. The pedobarographic mat was used to analyze the distribution of foot forces on the ground, the diagnostic system Wiva^® Science was used for gait analysis, and Kineod 3D was used for posture analysis. The Shapiro-Wilk test used for analysis showed inconsistency with normal distribution for all measurement parameters. The Mann-Whitney U test was used for the analysis, and the significance level was set at p ≤ 0.05.

RESULTS

Examination of the relationship between stabilometric and gait parameters showed that the position of the mandible in relation to maxilla has an important effect on gait rhythm, gait cycle duration, and right step duration time. Patients diagnosed with malocclusion showed high-speed walking rhythm in comparison to patients with Angle's class I (p = 0.010). The duration of the whole gait cycle (p = 0.007) and the duration of right step (p = 0.027) were prolonged in students without orthodontic disorders compared to the other.

CONCLUSIONS

The conducted study proved that there is correlation between the presence of a stomatognathic disorder and gait cycle parameters. There is a statistically noticeable correspondence between the position of the mandible in relation to maxilla and walking rhythm, gait cycle duration, and right step duration time. Namely, students who presented malocclusion had a high-speed walking rhythm and decreased duration of the gait cycle and of the right step. On the other hand, students without disorders (Angle's class I) showed low-speed rhythm and increased duration of the gait cycle and of the right step in comparison to Angle's classes II and III.

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.