Postural balance impairment of the trunk in adolescents with mesial ratio of dentition before and after surgical treatment in the presence and absence of congenital cervical spine abnormalities

Abstract

BACKGROUND: In the presence of mandibular malformations and malocclusion, an abnormal morphology of the cervical spine is often detected. Latent neurological abnormalities in patients with possible disorders of spinal cord conduction function are promising in assessing the degree of postural balance impairment, which is well diagnosed by stabilometry.
 AIM: To evaluate the dynamics of postural stability in adolescents with the mesial ratio of dentition, with and without congenital cervical spine abnormalities, before and after reconstructive operations on the jaws with a constructive bite.
 MATERIALS AND METHODS: Clinical, radiographic, and two-platform stabilometric studies were conducted in 31 patients aged 15–17 years with combined dentomaxillofacial anomalies, having a mesial ratio of dentition. The main group included 10 adolescents with various congenital cervical spine abnormalities detected by multispiral computed tomography (CT). The control group included 21 patients who did not have CT signs of cervical spine abnormalities. The stabilometric parameters of the movement of the general body pressure center and the pressure centers of the contralateral lower extremities were evaluated in these patients before surgical correction of the bite and from 1 month to 1 year after it.
 RESULTS: In the main group, postural balance impairment was noted, which was more pronounced before surgical treatment than those in the control group. This was manifested by frontal–sagittal violations of postural stability, pathological increase in the areas of statokinesiograms, linear velocities of the centers of pressure, and abnormally severe asymmetry of stabilometric parameters between the contralateral lower extremities. After the surgical correction of the bite, signs of postural balance deterioration were recorded in the control group: a significant increase in the coefficient, i.e., a sharp change in the direction of movement of the general center of pressure from 18% [15%–20%] to 23% [15%–31%], and the asymmetry of the linear velocities of the centers of pressure of the contralateral lower extremities significantly increased from 0.9 [0.3–1.6] to 2.2 [0.9–4.4] mm/s. In the main group, a positive trend was observed—a change in these parameters toward normalization: that is, a tendency to decrease the coefficient and a significant decrease in the rate of the centers of pressure.
 CONCLUSIONS: To improve the quality of comprehensive diagnostics and medical rehabilitation of adolescents with congenital and combined dentomaxillofacial anomalies, additional radiographic examination of the cervical spine in combination with stabilometric and kinematic assessment of posture is necessary.