The Stomatognathic System's Role in the Postural Stabilization in Subjects Suffering from Whiplash Injury. Part 2: Patients with Malocclusion

Abstract

Aim of this study is analyze the effects of dental occlusion on postural stability in patients with previous whiplash and malocclusion. Materials and methods: 30 adult patients with previous whiplash and malocclusion (crossbite, mandibular shift, bad alignment, edentulous spaces) were selected. The patients were suffering from masticatory muscles pain caused by clenching during sleep. Exclusion criteria: use of psych drugs. To simulate the conditions of sleep (with a reduction of proprio-and esteroceptive inputs for postural management performed by CNS), we used postural Romberg analysis (feet together, closed eyes) on stabilometric platform changing occlusal parameters only, under the following conditions: 1) in occlusal rest position, 2) in centric occlusion, 3) in clenching, 4) with occlusal disengage with cotton rolls and 5) in clenching on cotton rolls. Time of each test: 15 seconds. It was performed a statistical analysis with T-test comparing between them the mean of all tests. Results: stabilometry data (postural ball and ellipse) show better postural with occlusal disengage (in centric and in clenching), and a worsening in all tests with centric occlusion (with statistically significant difference -p<0.05). Conclusions: postural instability caused by whiplash increases muscles tone and dental clenching as compensatory effects, with onset of facial pain and a worsening of TMJ health in subjects with malocclusion. An occlusal disengage (like an occlusal splint to reduce clenching) induces better postural performances. Sostomatognathic system becomes a source of postural dysfunction and a cause of postural worsening.