Department of Prosthodontics, University Medical Center Göttingen, 37075, Göttingen, Germany.
Department of Psychology & Leibniz ScienceCampus Primate Cognition, University of Göttingen, 37073, Göttingen, Germany.
Clin Oral Investig. 2024 Aug 29;28(9):505. doi: 10.1007/s00784-024-05888-9.
Body posture of patients with temporomandibular disorders (TMD) has been investigated using different methods, whereas outcome and conclusions were controversial. The present clinical trial aimed to investigate the effects of splint therapy on global body posture.
24 subjects (20 females, 4 males; age 24.2 ± 4.0 years) with TMD symptoms were examined clinically (RDC/TMD) and subsequently, splint fabrication was initiated. Along with routine therapy, all subjects underwent three-dimensional pre- and post-treatment full body scans in standing and upright sitting posture using a Vitus Smart XXL 3D scanner. Each scan was acquired in triplicate and evaluated in duplicate, measuring twelve standing and nine sitting postural parameters. Influencing factors were analyzed using analysis of variance (ANOVA), and additional Bland-Altman analyses verified the significance of the ANOVA results.
The increase of Forward Head angles and the decrease of Round Shoulders angles were consistent for both positions and sides. Forward Head angles were significantly influenced by limited mandibular mobility and myofascial pain. Round Shoulders angles showed a significant correlation with myofascial pain, joint noises and the absence of limited mandibular mobility.
The influence of occlusal splints on global posture is limited and only small effects on cervicocranial parameters were found. In the present study, the average head position of post treatment measurements was more centered on the body's core, whereas the shoulders were tilted more anteriorly.
Understanding the limited influence of occlusal splints on cervicocranial parameters underscores the need for multimodal treatment strategies for TMD patients.
使用不同方法研究了颞下颌关节紊乱病（TMD）患者的身体姿势，但是结果和结论存在争议。本临床试验旨在研究夹板治疗对整体身体姿势的影响。
24 名 TMD 症状患者（20 名女性，4 名男性；年龄 24.2±4.0 岁）接受了临床检查（RDC/TMD），随后开始制作夹板。除了常规治疗外，所有患者还在站立和直坐姿势下使用 Vitus Smart XXL 3D 扫描仪进行了三维治疗前后全身扫描。每个扫描重复三次，分别重复两次，测量 12 个站立和 9 个坐姿姿势参数。使用方差分析（ANOVA）分析影响因素，并进行 Bland-Altman 分析以验证 ANOVA 结果的显著性。
头前伸角度的增加和圆肩角度的减小在两种姿势和两侧都是一致的。头前伸角度受下颌活动度受限和肌筋膜疼痛的显著影响。圆肩角度与肌筋膜疼痛、关节弹响和无下颌活动度受限有显著相关性。
咬合夹板对整体姿势的影响是有限的，仅发现对颈椎颅参数有较小的影响。在本研究中，治疗后测量的头部位置更居中于身体核心，而肩部更前倾。
理解咬合夹板对颈椎颅参数的有限影响强调了 TMD 患者需要采用多模式治疗策略。
