POSTURAL AND OCCLUSION ARTICLES

Some references have abstracts hyperlinked.  Click on the highlighted references for the abstract.

Bergamini C..Dental occlusion and body posture: a surface EMG study.Cranio. 2008 Jan;26(1):25-32.

Sakaguchi K, Mehta NR, Abdallah EF, Forgione AG, Hirayama H, Kawasaki T, Yokoyama A. Examination of the relationship between mandibular position and body posture.  Cranio. 2007 Oct;25(4):237-49.

<>Munhoz WC, Marques AP, de Siqueira JT.  Evaluation of body posture in individuals with internal temporomandibular joint derangement. Cranio. 2005 Oct;23(4):269-77.

Olmos SR, Kritz-Silverstein D, Halligan W, Silverstein ST. The effect of condyle fossa relationships on head posture. Cranio. 2005 Jan;23(1):48-52.TMJ Therapy Centre, La Mesa, CA 91942, USA. Steven@tmjtherapycentre.com
Although it is commonly accepted that there is an interrelationship between the temporomandibular joint (TMJ) and head posture, few, if any, previous studies have quantified this effect. The purpose of this study is to quantify the effect of a change in the condyle fossa relationship of symptomatic temporomandibular joints on head posture. Charts of 51 patients (N=10 men and N=41 women) with symptomatic TMJ pathology were reviewed. The condyle fossa relationships were measured pre- and posttreatment using sagittal corrected hypocycloidal tomography. The amount of slant between the shoulder and external auditory meatus (EAM) was measured in pre- and posttreatment photographs as an indicator of forward head posture; less slant indicates better posture. Subjects ranged in age from 13-74 years (mean=43.1) and had been treated for an average of 5 months. Comparisons with pre-treatment measures showed that after treatment, the amount of retrodiskal space was significantly increased by an average of 1.67 mm on the left side (t=-10.11, p<0.0001) and 1.92 mm on the right (t=-9.62, p<0.0001). Comparisons also showed that after treatment, the amount of slant between the shoulder and EAM decreased by 4.43 inches on average which was also significant (t=13.08, p<0.0001). Improvement in the condyle fossa relationship was related to decreased forward head posture. This suggests that optimizing mandibular condyle position should be considered in the management of forward head posture (adaptive posture).


D'Attilio M, Epifania E, Ciuffolo F, Salini V, Filippi MR, Dolci M, Festa F, Tecco S.  Cervical lordosis angle measured on lateral cephalograms; findings in skeletal class II female subjects with and without TMD: a cross sectional study. Cranio. 2004 Jan;22(1):27-44
Department of Orthodontics, University of Chieti, Italy.
The literature reports evidence of various types of correlations between cervical alterations and cervical pain, and the existence of cervical pain in subjects with temporomandibular joint internal derangement (TMD). The hypothesis of this study is that cervical lordosis angle (CVT/EVT angle) alteration on cephalometrics could be correlated to the presence of TMD. The cephalometric records of 50 females with documented TMD were compared with those of a control group of 50 females. The subjects in the sample were 25-35 years of age, average 28.9 years (SD, 3.2). Radiographs were taken in mirror position, and seventeen variables, including the CVT/EVT angle, were traced. Double measurements were made to evaluate method error using Dahlberg's formula. Pearson's correlation coefficient and Mann-Whitney's t-test were used to evaluate the data. Intra-group analysis showed significant correlations between the CVT/EVT angle and mandibular length (p<0.01), mandibular position (p<0.05), mandibular divergence (p<0.01), and overjet (p<0.01) in both groups. Between groups, the analysis showed significant differences in CVT/EVT angle (p<0.05), maxillary protrusion (p<0.01), mandibular protrusion (p<0.01), mandibular length (p<0.01), mandibular divergence (p<0.05), and overbite (p<0.05).


Sforza C, Colombo A, Turci M, Grassi G, Ferrario VF. Induced oral breathing and craniocervical postural relations: an experimental study in healthy young adults. Cranio. 2004 Jan;22(1):21-6
Department of Human Anatomy, via Mangiagalli 31, 1-20133 Milano, Italy. farc@unimi.it
The influence of induced oral breathing on head and craniocervical posture was studied in ten healthy young adults. After a baseline recording, oral respiration was induced by using a swimmer's type nose clip. The subjects were filmed 15 and 90 minutes after wearing the nose clip, immediately and 15 minutes after taking it off. The angles C7-tragion versus the true vertical, nasion-tragion versus the vertical, and C7-tragion-nasion were calculated, and the difference between the baseline and the four experimental recordings was computed. During the experiment, head and neck positions were modified in all subjects, but with a large variability for both the direction (flexion or extension) and the extent of the modification. Overall, the mean differences were minimal with large standard deviations. Differences between baseline and the experimental recordings were significant only for the C7-tragion versus the vertical angle (analysis of variance, p=0.0083). In conclusion, induced oral respiration may have a significant role in the alteration of head and craniocervical posture, but the effect was highly variable.


Fink M, Wahling K, Stiesch-Scholz M, Tschernitschek H.
 The functional relationship between the craniomandibular system, cervical spine, and the sacroiliac joint: a preliminary investigation. Cranio. 2003 Jul;21(3):202-8. [Dept. of Physical Medicine and Rehabilitation, OE-8300 Hannover Medical School, 30625 Hannover, Germany. m.g.fink@t-online.de]
The hypothesis of a functional coupling between the muscles of the craniomandibular system and the muscles of other body areas is still controversial. The purpose of this pilot study was to examine whether there is a relationship between the craniomandibular system, the craniocervical system and the sacropelvic region. To test this hypothesis, the prevalence and localization of dysfunction of the cervical spine and the sacroiliac joint were examined in a prospective, experimental trial. Twenty healthy students underwent an artificial occlusal interference, which caused an occlusal interference. The upper cervical spine (CO-C3) and the sacroiliac joint were examined before, during and after this experimental test. The primary outcome with these experimental conditions was the occurrence of hypomobile functional abnormalities. In the presence of occlusal interference, functional abnormalities were detected in both regions examined and these changes were statistically significant. The clinical implications of these findings may be that a complementary examination of these areas in CMD patients could be useful.

Motoyoshi M, Shimazaki T, Sugai T, Namura S, Biomechanical influences of head posture on occlusion: an experimental study using finite element analysis, The European Journal of Orthodontics 2002 24(4):319-326.

Leonard M, Posture training for TMD patients  J Am Dent Assoc 2000 May;131(5):564, 566, 568.

Nicolakis P; Nicolakis M; Piehslinger E; Ebenbichler G; Vachuda M; Kirtley C; Fialka-Moser V, "Relationship between craniomandibular disorders and poor posture" Cranio 2000 Apr;18(2):106-12.

Milani RS; De Periere DD; Lapeyre L; Pourreyron L, "Relationship between dental occlusion and posture" Cranio 2000 Apr;18(2):127-34.

Makofsky HW, "The influence of forward head posture on dental occlusion".Cranio 2000 Jan;18(1):30-9.

Gangloff P; Louis JP; Perrin PP, "Dental occlusion modifies gaze and posture stabilization in human subjects" Neurosci Lett 2000 Nov 3;293(3):203-6.

Michelotti A; Manzo P; Farella M; Martina R, "[Occlusion and posture: is there evidence of correlation?]" Minerva Stomatol 1999 Nov;48(11):525-34.

Kondo E; Aoba TJ, "Case report of malocclusion with abnormal head posture and TMJ symptoms" Am J Orthod Dentofacial Orthop 1999 Nov;116(5):481-93.

Fuentes R; Freesmeyer W; Henriquez J, "[Influence of body posture in the prevalence of craniomandibular dysfunction]" Rev Med Chil 1999 Sep;127(9):1079-85.

Sharifi Milani R; Deville de Periere D; Micallef JP, "Relationship between dental occlusion and visual focusing" Cranio 1998 Apr;16(2):109-18.

Benech A; Fasciolo A; De Gioanni PP; Madaro E, "[Evaluation of the posture of patients before and after orthodontic surgery]" Minerva Stomatol 1997 Sep;46(9):435-41.

Nobili A; Adversi R, "Relationship between posture and occlusion: a clinical and experimental investigation" Cranio 1996 Oct;14(4):274-85.

Zonnenberg AJ; Van Maanen CJ; Oostendorp RA; Elvers JW, "Body posture photographs as a diagnostic aid for musculoskeletal disorders related to TMD" Cranio 1996 Jul;14(3):225-32.

Hedrick PP, "Acute unilateral TMJ pain and sleep posture" J Gen Orthod 1996 Mar;7(1):21-3.

Carossa S; Catapano S; Previgliano V; Preti G, "[The incidence of craniomandibular disorders in patients with cervical dysfunctions. A clinico-statistical assessment]" Minerva Stomatol 1993 May;42(5):229-33.

Huggare JA; Raustia AM, "Head posture and cervicovertebral and craniofacial morphology in patients with craniomandibular dysfunction" Cranio 1992 Jul;10(3):173-7; discussion 178-9.

Horowitz L, Sarkin J, "Video Display Terminal Operation: Sympathetic Nervous System Activation and Temporomandibular Disorders" Journal of Chiropractic   1991  Dec;28(12): 29-34

Braun BL, "Postural differences between asymptomatic men and women and craniofacial pain patients." Arch Phys Med Rehabil 1991 Aug;72(9):653-6.

Magnano G, "[Relations between posture, locomotion, dentition, hand and TMJ, from origins to man]" Prog Odontoiatr 1991 May;4(5):45-55.

Rodrigues MJ; Lotzmann U; Rudolf W, "[Influence of occlusion on head posture, during periods of continuous intermaxillary pressure]" Stoma (Lisb) 1990 Jul;2(16):33-4, 37-8, 41-2.

Lotzmann U; Kobes LW; Rudolph W; Paula MJ, "[Influence of occlusion on head posture during prolonged phases of clenching]" Dtsch Zahnarztl Z 1989 Mar;44(3):162-4.

Miyata T; Satoh T; Shimada A; Umetsu N; Takeda T; Ishigami K; Ohki K, "[The relation between the condition of the stomatognathic system and the condition of whole body. I-1. Concerning the effects of a change of occlusion on upright posture especially on the locus of the body's gravity center]" Nippon Hotetsu Shika Gakkai Zasshi 1988 Dec;32(6):1233-40.

 Frumker SC; Kyle MA, "The dentist's contribution to rehabilitation of cervical posture and function: orthopedic and neurological considerations in the treatment of craniomandibular disorders" Basal Facts 1987;9(3):105-9.

Wright SM, "The effect of body posture on the preferred vertical dimension of occlusion" J Oral Rehabil 1984 Sep;11(5):467-76.

Levignac J; Heim JL; Berge M; Chalaye JC, "[Posture, behavior, occlusion and shape. Esthetics and perception]" Orthod Fr 1983;54(2):381-92.

Smith S., "Cardiac Stress Related to Occlusal Instability and Temporomandibular Joint Dysfunction: Report of a Case" Journal of American Osteopathic Association   1981  Jun; 80(10):  690-7

Burki NK, "The effects of changes in functional residual capacity with posture on mouth occlusion pressure and ventilatory pattern" Am Rev Respir Dis 1977 Nov;116(5):895-900.

Mohl N, "Head posture and its role in occlusion" Int J Orthod 1977 Mar;15(1):6-14.

Mohl ND, "Head posture and its role in occlusion" N Y State Dent J 1976 Jan;42(1):17-23.

Harnett J, "'How to' recognize/maintain mandibular posture." Bull Eleventh Dist Dent Soc 1975 Oct;13(6):12.

de Andrade NJ, "[Dental occlusion]" Sel Odontol (Sao Paulo) 1971 Apr;1(6):8-16.

Khoroshilkina FI; Malygin IM; Nesulkovskii IA; Tsyplenkov VG, "[Sinusbronchial pneumopathy and disturgances of posture in patients with sagittal anomalies of occlusion]" Stomatologiia (Mosk) 1970 Jul-Aug;49(4):65-7.

Wood GN, "Centric occlusion, centric relation, and the mandibular posture" J Prosthet Dent 1968 Oct;20(4):292-306.