Masticationpedia

Occlusion and Posture Abstract

Occlusion and Posture

Masticationpedia
Masticationpedia
Article by: Gianni Frisardi

Abstract
The relationship between dental occlusion and body posture has long fascinated clinicians because it sits at the crossroads of biomechanics, neurophysiology, and the everyday reality of patients who present with craniofacial symptoms together with “postural” complaints. This introductory chapter sets the conceptual stage for the section “Occlusion and Posture” by framing posture as a multi-sensory construct: the body’s orientation in space emerges from the continuous integration of visual, vestibular, and proprioceptive inputs, coordinated through spinal, brainstem, cerebellar, and cortical networks. Within this architecture, the craniomandibular system is a plausible—but not automatically causal—participant, because it is rich in proprioceptors and is functionally coupled to cervical and trunk musculature through both mechanical continuities and neural pathways.

A central theme is the scientific controversy: the literature contains data that appear to support a correlation between occlusal conditions and postural stability, and an equally robust body of evidence that refutes any clinically meaningful relationship. On one side, studies report measurable changes in body sway, muscular tone, head position, plantar pressure distribution, or gait parameters associated with jaw position, clenching, malocclusion traits, and temporomandibular disorders. These findings are often interpreted through two complementary explanatory models. The first involves “ascending” influences, where lower-limb or pelvic dysfunctions propagate through myofascial and neuromotor adaptations toward the cervical-craniofacial region. The second involves “descending” influences, where occlusal and mandibular anomalies may modulate trigeminal afferent activity, alter cervical muscle recruitment, and contribute to compensatory strategies along the axial skeleton and distal segments.

On the other side, multiple investigations—especially those using stabilometry and force platforms under standardized conditions—report high inter-individual variability and minimal differences between mandibular rest position and intercuspidation, or between habitual occlusion and experimentally modified conditions. These studies caution against turning posturography into a diagnostic shortcut for malocclusion, emphasizing that statistically significant correlations may be weak, inconsistent, or clinically irrelevant. In this perspective, persistent dental parameters (e.g., crossbite, midline shift, orthodontic history) frequently fail to predict postural control or plantar pressure patterns.

To navigate this tension, the chapter introduces a neurophysiological anchor: the trigeminal system is not a metaphor but an anatomical and functional gateway that can interact with vestibular and brainstem circuitry. A paradigmatic example is provided by Vestibular Evoked Myogenic Potentials (VEMPs), where acoustic stimulation can elicit reflex EMG responses in the masseter, demonstrating vestibulo-trigeminal coupling through mono- and polysynaptic circuits. Yet the existence of connectivity does not equal diagnostic permission: correlation must be demonstrated case-by-case, and the clinician must resist the temptation to infer causality from “known links” alone.

Finally, the chapter motivates the clinical trajectory of the section: subsequent chapters will move from theory to concrete cases, including patients who appear to present purely “occlusal” problems but in whom electrophysiology reveals a different etiology (e.g., neuronal hyperexcitability in bruxism assessed through the rcMIR recovery cycle). The goal is to teach a disciplined method: when posture and occlusion seem connected, we must test the hypothesis with reliable measures—static and dynamic—while remaining open to alternative explanations that may lie within central neuromotor control rather than within the dental arches.


Figure 2: Vestibular Evoked Myogenic Potentials


🧠 Three guiding questions (with essential answers)

1️⃣ Is there a real scientific correlation between dental occlusion and body posture? - The current scientific evidence does not support a universal or direct causal relationship. While some studies report associations between occlusal conditions and postural parameters, many well-controlled investigations show high variability and weak or clinically irrelevant correlations. Any relationship must therefore be evaluated case by case.

2️⃣ What role does the trigeminal system play in the interaction between occlusion and posture? - The trigeminal system represents a neurophysiological interface between the masticatory apparatus and central postural control networks, including vestibular and brainstem circuits. Its involvement demonstrates functional connectivity, but this connectivity alone does not justify diagnostic or therapeutic assumptions without objective neurophysiological evidence.

3️⃣ Why is it dangerous to infer postural diagnoses solely from occlusal findings? - Because anatomical and functional connections do not automatically imply causality. Relying exclusively on occlusal observations risks misdiagnosis, especially when central nervous system mechanisms—such as neuronal hyperexcitability—may underlie the clinical presentation. Objective tests and contextual clinical reasoning are essential to avoid diagnostic bias.

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Bibliography & references

  • Guez G., «The Posture (in Principles of Neural Science)», 1991». 
  • Guerraz M.; Bronstein A.M., «Ocular versus extraocular control of posture and equilibrium», 2008». 
  • Hamaoui A.; Frianta Y.; Le Bozec S., «Does increased muscular tension along the torso impair postural equilibrium in a standing posture?», 2011». 
  • Tardieu C.; Dumitrescu M.; Giraudeau A.; Blanc J.L.; Cheynet F.; Borel L., «Dental occlusion and postural control in adults», 2009». 
  • Munhoz W.C.; Hsing W.T., «Interrelations between orthostatic postural deviations and malocclusion», 2014». 
  • Myers T., «Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists», 2015». 
  • Pinganaud G.; Bourcier F.; Buisseret-Delmas C.; Buisseret P., «Primary trigeminal afferents to the vestibular nuclei in the rat», 1999». 
  • Bracco P.; Deregibus A.; Piscetta R., «Effects of different jaw relations on postural stability in human subjects», 2004». 
  • Manfredini D.; Castroflorio T.; Perinetti G.; Guarda-Nardini L., «Dental occlusion, body posture and temporomandibular disorders», 2012». 
  • Sakaguchi K.; Mehta N.R.; Abdallah E.F.; Forgione A.G.; Hirayama H.; Kawasaki T.; Yokoyama A., «Examination of the relationship between mandibular position and body posture», 2007». 
  • Cuccia A.; Caradonna C., «The relationship between the stomatognathic system and body posture», 2009». 
  • Michelotti A.; Buonocore G.; Farella M.; Pellegrino G.; Piergentili C.; Altobelli S.; Martina R., «Postural stability and unilateral posterior crossbite», 2006». 
  • Scharnweber B.; Adjami F.; Schuster G.; Kopp S.; Natrup J.; Erbe C.; Ohlendorf D., «Influence of dental occlusion on postural control and plantar pressure distribution», 2017». 
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