DYNAMIC POSTUROGRAPHY IN PATIENTS WITH ORTHODONTIC AND VESTIBULAR DISORDERS
Keywords:
dynamic posturography, malocclusions, vertigo, temporomandibular disordersAbstract
Posture of human body corresponds to a certain stable relationship between head, torso and limbs, where
a minimal amount of energy is needed for its support. Although clinicians in the field have studied the connection
between the muscle chains, maintaining balance of the body, and the musculature in the maxillofacial area (cervical,
masticatory), more can be studied and proven in the area. If there is a change of the center of gravity of the body, it
is certain that a negative change of posture has been diagnosed. Postural disorders are increasingly common
nowadays. The prevalence of musculoskeletal disorders is increasing as well, along with temporomandibular
disorders (TMD), vertigo, dizziness, tinnitus, memory loss and others.
The present study aims to demonstrate the need for complex examination of patients with symptoms from the audiovestibular
system, stomatognathic and other anatomical systems in the head and neck area.
In the present study, 40 (20 male and 20 female) patients who have passed through the Audio-vestibular and Sleep
laboratory of the University Medical and Dental Center at the Faculty of Dental Medicine of Medical University –
Varna in the period February – June 2022 were included. All of them were invited to fill out an informed consent
form. They were also given questionnaires to describe the symptoms, concerning audio-vestibular and
stomatognathic systems. Thorough examinations were performed by an ENT-specialist and a physician in dental
medicine. All patients were examined on a dynamic stabilometric platform, under different modalities – with eyes
open/closed, teeth clenched/relaxed, head tilted left and right, for fixed amount of time – 20 sec. Posturographic
platform is not a source of ionizing radiation.
Patients who reported pain and noise from the temporomandibular joints, when examined with the posturography
platform, shifted the center of gravity of the body more often backwards and to the right side (especially if the TMD
was bilateral). In patients who also had vestibular symptoms (dizziness, vertigo), with or without a disorder in the
mandibular joints, the center of gravity of the body was more often shifted back and to the right as well. Most of the
patients with the described displacement also had an orthodontic deformity. Based on intraoral dental examination,
cephalograms, and analysis, patients with Angle class 2 (distal bite), crossbite in the lateral area, laterognathia were
diagnozed, the first being the most common in patients with a shift in the center of gravity. In all studied patients, an
increase in the length of the stabilogram curve above the reference values of 150 mm was found. A change in the
feet - flat feet - was found in half of the patients, included in the study.
Postural problems can worsen existing symptoms from other systems with a disorder. Establishing the direction of
the displacement helps to establish the genesis of the disorder and directs the appropriate therapy, according to the
specific clinical case.
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