Abstract
Aim: Aim of this study is analyze the effects of dental occlusion on postural stability in patients with previous whiplash and normal occlusion.. Materials and Methods: 36 adult patients with previous whiplash and normal occlusion (good alignment, 1st class or mild 2nd class deep bite for mandibular retrusion) were selected. The patients were suffering from masticatory muscles pain caused by clenching during sleep. Exclusion criteria: Use of Psych drugs: To simulate the conditions of sleep (with a reduction of proprioand esteroceptive inputs for postural management performed by CNS), we used postural Romberg analysis (feet together, closed eyes) on stabilometric platform changing occlusal parameters only, under the following conditions: 1) in occlusal rest position, 2) in centric occlusion, 3) in clenching, 4) with occlusal disengage with cotton rolls and 5) in clenching on cotton rolls. Time of each test: 15 seconds. It was performed a statistical analysis with T-test comparing between them the mean of all tests. Results: Stabilometry data (postural ball and ellipse) show better postural performances in centric occlusion and clenching in centric occlusion, and a worsening in all tests with occlusal disengage (with statistically significant difference p<0.05). Conclusion: Postural instability caused by whiplash increases muscles tone and dental clenching as compensatory effects, with onset of facial pain. An occlusal disengage (like an occlusal splint to reduce clenching) induces a postural worsening in patients with normal occlusion, while centric occlusion increases the stability. These results suggest that stomatognathic organ has a new physiological function: the posture stabilization.
Highlights
Dental clenching is a condition that can induce dental abfraction, TMJ disorders, tension-type headache and facial pain caused by masticatory muscles hypertonus
This testing job was composed in two parts since there were two groups of patients depending on their occlusal characteristics: group 1 was formed by patients with good dental occlusion, while group 2 was formed by patients with malocclusion
The average values related to the postural ball length have been: 1. in rest position: 140.31 St. dev. 85.11; 2. in centric occlusion: 123.88 St. dev. 80.54; 3. clenching in centric occlusion: 118.69 St. dev. 83.99; 4. with occlusal disengage: 139.30 St. dev. 101.82; 5
Summary
Dental clenching is a condition that can induce dental abfraction, TMJ disorders, tension-type headache and facial pain caused by masticatory muscles hypertonus. A meta-analysis of patients suffering from clenching and attending to Cranio-Facial Pain Center of Dental Clinic of Milan-Bicocca University shows that many patients have a story of a previous whiplash, a condition that induces postural alterations [7-10], as instability, dizziness, lumbar and cervical pain. These patients are suffering from clenching, TMJ pain and facial pain for muscle hyperactivity. The importance of this job is to technically evaluate the importance of the stomatognatic system in the postural stabilization, which had been previously disturbed by a traumatic event such as whiplash
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