Effect of Occlusal Splints on Posture Balance in Patients with Temporomandibular Joint Disorder: A Prospective Study
Amine el Zoghbi, Mohamad Halimi, Joseph Hobeiche, Camille Haddad
Occlusal splint, Posture, Study type other, Temporomandibular disorders, Temporomandibular joints
Citation Information :
el Zoghbi A, Halimi M, Hobeiche J, Haddad C. Effect of Occlusal Splints on Posture Balance in Patients with Temporomandibular Joint Disorder: A Prospective Study. J Contemp Dent Pract 2021; 22 (6):615-619.
Aim and objective: Force platforms are widely used to evaluate the relationship between bodily posture and jaw positions. The aim and objective of this clinical prospective study was to evaluate the effect of occlusal splints on bodily posture using force platforms.
Materials and methods: Forty-seven female patients with temporomandibular disorders (TMD) underwent a clinical and postural examination before and during an occlusal treatment with an upper splint. Six postural stabilometric examinations were performed under different visual conditions. Postural stability was assessed using a force platform (SATEL). Subjects were evaluated in static and dynamic conditions, with open and closed eyes, at baseline, at 1 week, and at 3 months. Changes in stabilometric parameters (sway area and sway length) were assessed and compared.
Results: In static and dynamic positions, the sway surface area decreased significantly after the occlusal guard placement with closed eyes (p-value, 0.012). Likewise, the sway surface area decreased significantly in the dynamic lateral position with closed eyes (p-value, 0.018) and in anteroposterior dynamic position with open eyes (p-value, 0.031). The mean sway length decreased significantly after the placement of the occlusal guard when participants were in the lateral position with open eyes (p-value, 0.025) and in the anteroposterior position with open eyes (p-value, 0.014). On a 3-month assessment, the mean surface and mean length decreased significantly after the placement of the occlusal guard for practically all the static and dynamic positions.
Conclusion: The sway surface area and sway length decreased significantly with the use of occlusal splints
Clinical significance: In female patients with TMD, the use of an occlusal splint is associated with a postural improvement evaluated by posturo-stabilometric tests.
Amantéa DV, Novaes AP, Campolongo GD, et al. A importância da avaliação postural no paciente com disfunção da articulação temporomandibular. Acta Ortopédica Bras 2004;12(3):155–159. DOI: 10.1590/S1413-78522004000300004.
Chaves P de J, Oliveira FEM de, Damázio LCM. Incidence of postural changes and temporomandibular disorders in students. Acta Ortopédica Bras 2017;25(4):162–164. DOI: 10.1590/1413-785220172504171249.
Parker MW. A dynamic model of etiology in temporomandibular disorders. J Am Dent Assoc 1939 1990;120(3):283–290. DOI: 10.14219/jada.archive.1990.0045.
Jaeger JO, Oakley PA, Moore RR, et al. Resolution of temporomandibular joint dysfunction (TMJD) by correcting a lateral head translation posture following previous failed traditional chiropractic therapy: a CBP® case report. J Phys Ther Sci 2018;30(1):103–107. DOI: 10.1589/jpts.30.103.
Wright EF, Domenech MA, Fischer JR. Usefulness of posture training for patients with temporomandibular disorders. J Am Dent Assoc 1939 2000;131(2):202–210. DOI: 10.14219/jada.archive.2000.0148.
Hong SW, Lee JK, Kang JH. Relationship among cervical spine degeneration, head and neck postures, and myofascial pain in masticatory and cervical muscles in elderly with temporomandibular disorder. Arch Gerontol Geriatr 2019;81:119–128. DOI: 10.1016/j.archger.2018.12.004.
Solow B, Tallgren A. Head posture and craniofacial morphology. Am J Phys Anthropol 1976;44(3):417–435. DOI: 10.1002/ajpa. 1330440306.
Santander H, Miralles R, Jimenez A, et al. Influence of stabilization occlusal splint on craniocervical relationships. Part II: electromyographic analysis. Cranio J Craniomandib Pract 1994;12(4):227–233. DOI: 10.1080/08869634.1994.11678026.
Ormeño G, Miralles R, Santander H, et al. Body position effects on sternocleidomastoid and masseter EMG pattern activity in patients undergoing occlusal splint therapy. Cranio J Craniomandib Pract 1997;15(4):300–309. DOI: 10.1080/08869634.1997.11746024.
Opdebeeck H, Bell WH, Eisenfeld J, et al. Comparative study between the SFS and LFS rotation as a possible morphogenic mechanism. Am J Orthod 1978;74(5):509–521. DOI: 10.1016/0002-9416(78)90026-x.
Lee WY, Okeson JP, Lindroth J. The relationship between forward head posture and temporomandibular disorders. J Orofac Pain 1995;9(2):161–167.
Nicolakis P, Nicolakis M, Piehslinger E, et al. Relationship between craniomandibular disorders and poor posture. Cranio J Craniomandib Pract 2000;18(2):106–112. DOI: 10.1080/08869634.2000.11746121.
Valentino B, Melito F, Aldi B, et al. Correlation between interdental occlusal plane and plantar arches. An EMG study. Bull Group Int Rech Sci Stomatol Odontol 2002;44(1):10–13.
Cuccia AM. Interrelationships between dental occlusion and plantar arch. J Bodyw Mov Ther 2011;15(2):242–250. DOI: 10.1016/j.jbmt.2010.10.007.
Cuccia A, Caradonna C. The relationship between the stomatognathic system and body posture. Clin Sao Paulo Braz 2009;64(1):61–66. DOI: 10.1590/s1807-59322009000100011.
Gonzalez HE, Manns A. Forward head posture: its structural and functional influence on the stomatognathic system, a conceptual study. CRANIO® 1996;14(1):71–80. DOI: 10.1080/08869634.1996.11745952.
Clark GT, Green EM, Dornan MR, et al. Craniocervical dysfunction levels in a patient sample from a temporomandibular joint clinic. J Am Dent Assoc 1987;115(2):251–256. DOI: 10.14219/jada.archive.1987.0231.
Silveira W da, Mello FC de Q, Guimarães FS, et al. Postural alterations and pulmonary function of mouth-breathing children. Braz J Otorhinolaryngol 2010;76(6):683–686. DOI: 10.1590/S1808-86942010000600002
Arumugam P, Padmanabhan S, Chitharanjan AB. The relationship of postural body stability and severity of malocclusion. APOS Trends Orthod 2016;6(4):205–210. DOI: 10.4103/2321-1407.186436.
Pradham NS, White GE, Mehta N, et al. Mandibular deviations in TMD and non-TMD groups related to eye dominance and head posture. J Clin Pediatr Dent 2001;25(2):147–155. DOI: 10.17796/jcpd.25.2.j7171238p2413611.
Baldini A, Nota A, Tripodi D, et al. Evaluation of the correlation between dental occlusion and posture using a force platform. Clin Sao Paulo Braz 2013;68(1):45–49. DOI: 10.6061/clinics/2013(01)OA07.
Cuccia AM, Caradonna C. Binocular motility system and temporomandibular joint internal derangement: a study in adults. Am J Orthod Dentofac Orthop 2008;133(5):640.e15–640.e20. DOI: 10.1016/j.ajodo.2007.10.034.
Okeson JP, Moody PM, Kemper JT, et al. Evaluation of occlusal splint therapy and relaxation procedures in patients with temporomandibular disorders. J Am Dent Assoc 1939 1983;107(3):420–424. DOI: 10.14219/jada.archive.1983.0275.
Kovaleski WC, De Boever J. Influence of occlusal splints on jaw position and musculature in patients with temporomandibular joint dysfunction. J Prosthet Dent 1975;33(3):321–327. DOI: 10.1016/s0022-3913(75)80090-4.
Landulpho AB, Silva WABE, Silva FAE, et al. Electromyographic evaluation of masseter and anterior temporalis muscles in patients with temporomandibular disorders following interocclusal appliance treatment: masseter and anterior temporalis muscles in patients with temporomandibular disorders. J Oral Rehabil 2004;31(2):95–98. DOI: 10.1046/j.0305-182x.2003.01204.x.
Kibana Y, Ishijima T, Hirai T. Occlusal support and head posture. J Oral Rehabil 2002;29(1):58–63. DOI: 10.1046/j.1365-2842.2002.00794.x.
Hiyama S, Ono T, Ishiwata Y, et al. First night effect of an interocclusal appliance on nocturnal masticatory muscle activity: nocturnal muscle activity with an interocclusal appliance. J Oral Rehabil 2003;30(2):139–145. DOI: 10.1046/j.1365-2842.2003.01017.x.
Perinetti G, Contardo L, Silvestrini-Biavati A, et al. Dental malocclusion and body posture in young subjects: a multiple regression study. Clin Sao Paulo Braz 2010;65(7):689–695. DOI: 10.1590/S1807-59322010000700007.
Scharnweber B, Adjami F, Schuster G, et al. Influence of dental occlusion on postural control and plantar pressure distribution. Cranio J Craniomandib Pract 2017;35(6):358–366. DOI: 10.1080/08869634.2016.1244971.
Nota A, Tecco S, Ehsani S, et al. Postural stability in subjects with temporomandibular disorders and healthy controls: a comparative assessment. J Electromyogr Kinesiol 2017;37:21–24. DOI: 10.1016/j.jelekin.2017.08.006.
Baldini A, Nota A, Assi V, et al. Intersession reliability of a posturo-stabilometric test, using a force platform. J Electromyogr Kinesiol 2013;23(6):1474–1479. DOI: 10.1016/j.jelekin.2013.08.003.
Perinetti G, Marsi L, Castaldo A, et al. Is postural platform suited to study correlations between the masticatory system and body posture? A study of repeatability and a meta-analysis of reported variations. Prog Orthod 2012;13(3):273–280. DOI: 10.1016/j.pio.2011.12.003.
Gelb H. Relating temporomandibular joint dysfunction and occlusal imbalance to implant dentistry. Oral Implantol 1977;6(4): 584–597.
Daly P, Preston CB, Evans WG. Postural response of the head to bite opening in adult males. Am J Orthod 1982;82(2):157–160. DOI: 10.1016/0002-9416(82)90494-8.
Dias AA, Redinha LA, Silva LM, et al. Effects of dental occlusion on body sway, upper body muscle activity and shooting performance in pistol shooters. Appl Bionics Biomech 2018;2018:9360103. DOI: 10.1155/2018/9360103.
Cortese S, Mondello A, Galarza R, et al. Postural alterations as a risk factor for temporomandibular disorders. Acta Odontol Latinoam 2017;30(2):57–61.
Clauzade MA, Darraillans B. Concept ostéopathique de l'occlusion. SEOO; 1989.