Postura de cabeça nas deformidades dentofaciais classe II e classe III

Abstract

Conflict of interest: non-existentAccording to Grade et al. 2 , the temporomandibular joint (TMJ) represents the connection of the mandible to the base of the skull, which in turn presents muscle and ligament connections with the cervical region. Together, they form a functional system denoted cranio-cervico-mandibular. Studies concerning this intimate connection have been designed in order to confirm that changes of posture of the head and of other body parts may lead to functional alteration of the masticatory system and vice versa [3][4][5][6][7][8] . It has been observed that the molar relation seems to play an important role in this connection and that certain malocclusion problems may be related to changes in head posture more than others 9 . Several authors have studied the presence of changes in head posture in patients with malocclusion. Some of them have stated that patients with class II and class III malocclusion present changes in head posture on the sagittal plane 1,[10][11][12][13] , as well as on the frontal and transverse plane [13][14][15] . Although there is a consensus about the connection existing between the stomatognathic and ABSTRACT Purpose: this study investigates whether there is a difference in head posture between groups with different dentofacial deformities (class II and class III) and a group with no deformity. Method: 25 volunteers aged from 16 to 40 year old took part in the study. Ten patients had a diagnosis of class II dentofacial deformity, 15 had a diagnosis of class III skeletal deformity, and 15 healthy volunteers matched for sex and age to the group with deformity were used as a control group. Head posture was first checked, followed by evaluation through postural photography (photogrammetry). Results: there was no significant difference (p>0.05) between groups regarding postural evaluation by photogrammetry. However, postural evaluation using clinical inspection, revealed anterior head posture among subjects with class II dentofacial deformity compared to subjects with class III deformity (p = 0.001) and to control group (p = 0.001). The percentage of class II dentofacial deformity subjects with neutral head posture was also lower compared to class III dentofacial deformity (p = 0.008) and to control group (p = 0.001). Conclusion: subjects with class II dentofacial deformity may show anteriorization of the head. There is no influence of the deformity on the increase or reduction of the head-neck angle when analyzed by photogrammetry.

Avaliação de sinais e sintomas da disfunção temporomandibular e sua relação com a postura cervical

“…Pesquisadores da Universidade de Ribeirão Preto concluíram que indivíduos que possuem deformidades dentofaciais classe II apresentam anteriorização da cabeça (100%), quando comparados aos que possuem deformidade dentofacial classe III (33,3%) 11 . Sugerimos, portanto, a realização de futuras pesquisas com inclusão da avaliação oclusal dentária.…”

“…A distância entre a câmera e a participante foi padronizada em um metro 11 . Devido ao fato de cada indivíduo ter sua altura própria, a altura do tripé não foi padronizada; entretanto, a cabeça da participante foi sempre colocada no centro do enquadramento e perpendicular ao perfil facial para evitar distorções.…”

Malocclusion influence on balance and posture: a systematic review.

“…Deda et al (15) in their study, compared the position of the head in different classes (Class I, II and III) by photogrammetry and clinical inspection the sample of twenty-five patients diagnosed with malocclusion. There was no significant difference between classes and influenced malocclusion on the angle head-neck evaluated by photogrammetry.…”

“…Deda et al (15) Comparing a group of patients with malocclusion with a control group and investigate whether there are differences between head posture.…”

Correlations between malocclusion and anomalies in the posture

“…The correlation between patients with malocclusion and Helkimo Index ≥ 5 with the worst asymmetry trunk and better performance in the Fukuda test was found� 2012 Deda et al� [5] Comparing a group of patients with malocclusion with a control group and investigate whether there are differences between head posture� 25 Regarding the evaluation by photogrammetry, there was no significant difference between groups� Clinical inspection has achieved significant results, where 100% of Class II subjects had forward head and 73�3% in the control group, showed neutral head position�…”