Modifica di Occlusion and Posture (sezione)

====Tmj disorders and posture====
It has been shown that changes in the temporomandibular joint (TMJ) can have a direct impact on muscle activity in terms of posture, stability and physical performance.<ref name=":2" /><ref>Moon H.J., Lee Y.K. The relationship between dental occlusion/temporomandibular joint status and general body health: Part 1. Dental occlusion and TMJ status exert an influence on general body health. J. Altern. Complement. Med. 2011;17:[tel:995–1000 995–1000]. doi: 10.1089/acm.2010.0739.</ref><ref>Souza J.A., Pasinato F., Correa E.A., da Silva A.M. Global body posture and plantar pressure distribution in individuals with and without temporomandibular disorder: A preliminary study. J. Manip. Physiol. Ther. 2014;37:407–414.</ref>  However, there is a lack of high-quality studies using advanced measurement tools to better understand the phenomenon under investigation.<ref>Ferrillo M., Marotta N., Giudice A., Calafiore D., Curci C., Fortunato L., Ammendolia A., de Sire A. Effects of occlusal splints on spinal posture in patients with temporomandibular disorders: A systematic review. Healthcare. 2022;10:739. doi: 10.3390/healthcare10040739.</ref> The study authors evaluated the impact of masticatory abnormalities on postural control and focuses on evaluating individuals with specific malocclusions that determine the anteroposterior position of the mandible. According to some researchers, malocclusion, like TMD, can affect the osteoarticular system of the whole body and become a source of persistent pain and favor the development and  to become chronic of some postural defects. According to the cited authors, occlusal disturbances can lead to an altered stimulation of the periodontal proprioceptors, causing changes in the tension of the neck muscles and postural muscles and changes in the position of the head, followed by compensatory changes in the anatomical regions in their immediate vicinity. Over time, this can affect the posture, center of gravity position, or foot contact with the ground.<ref name=":0" /><ref name=":11" /><ref name=":12" /><ref>Saccucci M., Tettamanti L., Mummolo S., Polimeni A., Festa F., Tecco S. [https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21801357/ Scoliosis and dental occlusion: A review of the literature.] Scoliosis. 2011;6:1–15. doi: 10.1186/1748-7161-6-15. </ref><ref>Sforza C., Tartaglia G.M., Solimene U., Morgan V., Kaspranskiy R.R., Ferrario V.F. Occlusion, sternocleidomastoid muscle activity, and body sway: A pilot study in male astronauts. Cranio. 2006;24:43–49. doi: 10.1179/crn.2006.008</ref>


<blockquote>[[File:Question 2.jpg|left|50x50px]]This could also be true but at the same time it should be demonstrable in order not to make diagnostic errors such as the one we will present in the section dedicated to 'Occlusion and Posture. Indeed, the patient we will present exclusively reported a masticatory disorder such as to require continuous rehabilitative reconstructions from his dentist. How can we demonstrate this occlusal disturbance at the neuromotor level such that it can also condition the vestibular system, the cerebellum and other brain centres?
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[[File:Pz.Arc006.jpg|599x599px|'''Figure 2:'''Trigeminal electrophysiological responses.|center]]'''Figure 2:'''Trigeminal electrophysiological responses.
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Faced with a marked asymmetry such as the one shown in Figure 2, we certainly cannot deny a trigeminal disorder which is often related to a malocclusion. In Figure 2A we can see a slight asymmetry of the interferential EMG trace between the right and left masseter as well as the MEPs of the trigeminal root (Figure 2B) as well as the absence of the action potential on the right masseter in the mandibular reflex responses (Figure 2C ). As we will see in the chapters concerning this patient, these abnormal trigeminal electrophysiological responses have nothing to do with occlusal disturbances, much less postural disturbances.</blockquote>However, there is still a gap in scientific knowledge on the relationship between craniofacial structure and spinal postural control in patients with malocclusion. Furthermore, the available documents show problems related to the small number of subjects, the small number of tested parameters or the selection of reliable measurement tools.<ref name=":8" /><ref>Michelotti A., Buonocore G., Manzo P., Pellegrino G., Farella M. Dental occlusion and posture: An overview. Prog. Orthod. 2011;12:53–58. doi: 10.1016/j.pio.2010.09.010. </ref><ref>Ishizawa T., Xu H., Onodera K., Ooya K. [https://oss.jocpd.com/files/article/20220826-1205/pdf/JOCPD.30.2.165.pdf Weight distributions on soles of feet in the primary and early permanent dentition with normal occlusion.] J. Clin. Pediatr. Dent. 2005;30:165–168. doi: 10.17796/jcpd.30.2.8x4727137678061m.</ref>

Malocclusion, which these studies focus on, can result from abnormalities in the structure and alignment of the bones of the jaw and mandible in relation to each other or from an abnormal arrangement of the dental arches.