Department of Maxillofacial Surgery, TMD Clinic, University of Padova, Carrara, Italy.
J Oral Rehabil. 2012 Jun;39(6):463-71. doi: 10.1111/j.1365-2842.2012.02291.x. Epub 2012 Mar 21.
The aim of this investigation was to perform a review of the literature dealing with the issue of relationships between dental occlusion, body posture and temporomandibular disorders (TMD). A search of the available literature was performed to determine what the current evidence is regarding: (i) The physiology of the dental occlusion-body posture relationship, (ii) The relationship of these two topics with TMD and (iii) The validity of the available clinical and instrumental devices (surface electromyography, kinesiography and postural platforms) to measure the dental occlusion-body posture-TMD relationship. The available posturographic techniques and devices have not consistently found any association between body posture and dental occlusion. This outcome is most likely due to the many compensation mechanisms occurring within the neuromuscular system regulating body balance. Furthermore, the literature shows that TMD are not often related to specific occlusal conditions, and they also do not have any detectable relationships with head and body posture. The use of clinical and instrumental approaches for assessing body posture is not supported by the wide majority of the literature, mainly because of wide variations in the measurable variables of posture. In conclusion, there is no evidence for the existence of a predictable relationship between occlusal and postural features, and it is clear that the presence of TMD pain is not related with the existence of measurable occluso-postural abnormalities. Therefore, the use instruments and techniques aiming to measure purported occlusal, electromyographic, kinesiographic or posturographic abnormalities cannot be justified in the evidence-based TMD practice.
本研究旨在对涉及牙合、体态与颞下颌关节紊乱病(TMD)之间关系的文献进行综述。检索了现有文献,以确定目前关于以下方面的证据:(i)牙合与体态关系的生理学,(ii)这两个主题与 TMD 的关系,以及(iii)现有临床和仪器设备(表面肌电图、运动学和姿势平台)测量牙合-体态-TMD 关系的有效性。现有的姿势描记技术和设备并未一致发现体态与牙合之间存在任何关联。这种结果很可能是由于调节身体平衡的神经肌肉系统中存在许多代偿机制。此外,文献表明 TMD 通常与特定的咬合状况无关,并且它们与头部和身体姿势也没有任何可检测的关系。评估体态的临床和仪器方法并未得到绝大多数文献的支持,主要是因为体位的可测量变量存在广泛差异。总之,没有证据表明牙合与姿势特征之间存在可预测的关系,而且 TMD 疼痛的存在与可测量的咬合-姿势异常的存在无关。因此,在基于证据的 TMD 实践中,不能使用旨在测量所谓的咬合、肌电图、运动学或姿势异常的仪器和技术。