Enfoque integral en el diagnóstico del patrón esquelético maxilomandibular, la postura corporal y cráneo-cervical / A comprehensive approach to the diagnosis of the maxillomandibular skeletal pattern, body posture and craniocervical position

Introducción: Los principios biomecánicos de cabeza y cuello cobran un interés especial en el campo de la ortodoncia y la ortopedia dentomaxilofacial. Cualquier anomalía debe ser analizada y tratada dentro del sistema cráneo-cérvico-mandibular con un enfoque integral. Objetivo: Describir la relación entre el patrón esquelético maxilomandibular sagital, la postura corporal y la posición cráneo-cervical en adolescentes. Métodos: Estudio descriptivo, transversal, desarrollado entre marzo del 2018 a junio del 2019. La muestra estuvo conformada por 105 adolescentes del séptimo grado de la ESBU "Eduardo Anoceto Rega", de Santa Clara. Se determinó el patrón esquelético maxilomandibular de clase I, II y III midiendo la convexidad facial del cefalogramas de Ricketts; la posición cráneo-cervical de extensión, normoinclinación y flexión con el cefalograma de Rocabado; el tipo de postura con el método de Bricot. Se siguieron las normas éticas y fueron aplicados los estadígrafos chi cuadrado, F de Fisher y estadístico de Welch. Resultados: La postura D (espalda plana y plano escapular anterior) predominó en todas las clases esqueléticas 64,76 por ciento de los adolescentes, seguido de la postura C (plano escapular posterior). En la clase II, después de la postura D siguió la postura B (plano escapular y glúteo alineados con aumento de las curvas anteriores) con un 6,22 por ciento. Predominó la normoinclinación cráneo-cervical 46,67 por ciento y la flexión 42,86 por ciento. En la clase III predominó la flexión y el ángulo posteroinferior de Rocabado mayor respecto a las otras clases esqueléticas de 107º. Conclusiones: La posición del cráneo respecto a las estructuras cervicales, asociada a las características de cada clase esquelética, puede ser un indicador importante en el diagnóstico morfológico. A pesar de las muchas investigaciones en este campo, aún no se puede hablar de consenso en cuanto al grado de relación entre la postura craneocervical y las maloclusiones(AU)

Introduction: Head and neck biomechanical principles are particularly relevant in the fields of orthodontics and dentomaxillofacial orthopedics. Any anomaly should be analyzed and treated within the cranio-cervical-mandibular system applying a comprehensive approach. Objective: Describe the relationship between the sagittal maxillomandibular skeletal pattern, body posture and craniocervical position in adolescents. Methods: A descriptive cross-sectional study was conducted from March 2018 to June 2019. The study sample was 105 adolescents attending seventh grade at Eduardo Anoceto Rega junior high school in Santa Clara. Determination was made of maxillomandibular skeletal patterns Classes I, II and III, measuring the facial convexity in Ricketts' cephalograms, craniocervical extension, normal inclination and flexion positions with Rocabado's cephalogram, and posture type with Bricot's method. Ethical standards were complied with. Use was made of the statistical tests chi-square, Fisher's F and Welch's. Results: Posture D (flat back and anterior scapular plane) prevailed in all skeletal classes: 64.76 percent of the adolescents, followed by posture C (posterior scapular plane). In Class II, posture D was followed by posture B (scapular and gluteal plane aligned with increased anterior curves): 6.22 percent. A predominance was observed of craniocervical normal inclination: 46.67 percent and flexion: 42.86 percent. In Class III, Rocabado's flexion and posteroinferior angle were more common than the remaining 107º skeletal classes. Conclusions: Cranial position with respect to cervical structures, according to the characteristics of each skeletal class, may be an important indicator in morphological diagnosis. Despite the large number of studies conducted in this field, consensus has not been achieved about the degree of relationship between craniocervical posture and malocclusions(AU)

Postura craneocervical como factor de riesgo en la maloclusión / Craniocervical posture as a risk factor for malocclusion

Introducción: los trastornos de la postura craneocervical han sido asociados como factores de riesgo de las enfermedades ortopédicas y, a su vez, son considerados afecciones propias, pero no existen suficientes estudios que los relacionen con la maloclusión dental. Objetivo: determinar si los trastornos de la postura craneocervical constituyen un factor de riesgo en la maloclusión de los pacientes atendidos en la Clínica Victoria de Santa Clara en el período comprendido entre octubre de 2012 y febrero de 2013. Métodos: se realizó un estudio observacional descriptivo de corte transversal donde se formaron 2 grupos, uno con pacientes con maloclusión y otro sin maloclusión, cada uno con 90 pacientes. Para determinar la prevalencia de los trastornos de la postura craneocervical, se emplearon la prueba de convergencia ocular, la prueba de rotación de la cabeza y la alteración del plano biclavicular. Resultados: en el grupo con maloclusión prevalecieron las féminas (55,55 por ciento); los principales factores identificados correspondieron a la herencia (85,55 por ciento), hábitos deformantes (63,33 por ciento), pérdida prematura de dientes (43,33 por ciento) y anormalidades de la musculatura bucal (24,44 por ciento). La prevalencia de los trastornos posturales fue del 97,77 por ciento en el grupo con maloclusión contra el 48,88 por ciento del control; tuvo una relación muy altamente significativa con la maloclusión y un odd ratio de 46,00. Conclusiones: existe un predominio del sexo femenino en el grupo de pacientes con maloclusión y una prevalencia del sexo masculino en el grupo control. Los principales factores de riesgo relacionados con la maloclusión de forma muy altamente significativa son los de mayor prevalencia. Hay predominio de los trastornos de la postura craneocervical en el grupo con maloclusión, presentando una relación muy altamente significativa con esta enfermedad, lo cual constituye un factor de riesgo que incrementa 46 veces más el riesgo de padecer de maloclusión(AU)

Introduction: craniocervical posture disorders have been viewed as risk factors for orthopedic conditions and as separate conditions themselves, but there are not sufficient studies relating them to dental malocclusion. Objective: determine whether craniocervical posture disorders constitute a risk factor for malocclusion in patients cared for at Victoria de Santa Clara clinic from October 2012 to February 2013. Methods: an cross-sectional observational descriptive study was conducted for which two groups were formed: one with patients with malocclusion and the other with patients without malocclusion. Each group was composed of 90 patients. Ocular convergence, head rotation, and biclavicular plane alteration tests were used to determine the prevalence of craniocervical posture disorders. Results: female gender prevailed in the malocclusion group (55.55 percent). The main factors identified were inheritance (85.55 percent), deforming habits (63.33 percent), premature tooth loss (43.33 percent) and oral muscle anomalies (24.44 percent). Prevalence of posture disorders was 97.77 percent in the malocclusion group vs. 48.88 percent in the control group, with a highly significant relationship to malocclusion and an odd ratio of 46.00. Conclusions: female gender prevailed in the malocclusion group, whereas male gender predominated in the control group. The most prevalent risk factors are those related to malocclusion in a highly significant manner. A predominance was found of craniocervical posture disorders in the malocclusion group, with a highly significant relationship to malocclusion, a factor increasing 46 times the risk of suffering from the condition(AU)

Static body postural misalignment in individuals with temporomandibular disorders: a systematic review

BACKGROUND: The association between body postural changes and temporomandibular disorders (TMD) has been widely discussed in the literature, however, there is little evidence to support this association. OBJECTIVES: The aim of the present study was to conduct a systematic review to assess the evidence concerning the association between static body postural misalignment and TMD. METHOD: A search was conducted in the PubMed/Medline, Embase, Lilacs, Scielo, Cochrane, and Scopus databases including studies published in English between 1950 and March 2012. Cross-sectional, cohort, case control, and survey studies that assessed body posture in TMD patients were selected. Two reviewers performed each step independently. A methodological checklist was used to evaluate the quality of the selected articles. RESULTS: Twenty studies were analyzed for their methodological quality. Only one study was classified as a moderate quality study and two were classified as strong quality studies. Among all studies considered, only 12 included craniocervical postural assessment, 2 included assessment of craniocervical and shoulder postures,, and 6 included global assessment of body posture. CONCLUSION: There is strong evidence of craniocervical postural changes in myogenous TMD, moderate evidence of cervical postural misalignment in arthrogenous TMD, and no evidence of absence of craniocervical postural misalignment in mixed TMD patients or of global body postural misalignment in patients with TMD. It is important to note the poor methodological quality of the studies, particularly those regarding global body postural misalignment in TMD patients. .

Postura craneocervical en pacientes infantiles después de la terapia con mentonera: un estudio piloto / Craneocervical posture in children after treatment with chincap: a pilot study

Introducción: el propósito del presente estudio fue describir los cambios en la postura craneocervical en unapoblación infantil con clase II esquelética por prognatismo mandibular, luego de la utilización de mentonera con placa de acetato inferior para levantar la mordida. Métodos: la muestra consistió de once niños (siete niñas y cuatro niños). A cada niño le fueron tomadas tres radiografías cefálicas laterales en posición natural de cabeza (mirando de frente a un espejo), con ligero contacto oclusal. La primera radiografía (T1) fue tomada antes de iniciar la utilización de la mentonera, la segunda (T2), cuatro meses después de su uso y la tercera (T3), cuatro meses después de retirada. Para el análisis se emplearon medidas lineales y angulares, se realizó análisis descriptivo de las variables y se utilizaron las pruebas de normalidad (Shapiro-Wilk) y Friedman. Resultados: el análisis estadístico no mostró diferencias significativas en ninguna de las variables analizadas, y en ninguno de los momentos evaluados. Conclusión: a pesar de la gran variabilidad individual en la postura craneal, cervical y craneocervical de los niños evaluados, en general no se observaron en esta muestra cambios significativos en la columna cervical, luego del tratamiento con mentonera y placa de acetato inferior que levantaba la mordida.

Introduction: the aim of this study was to describe the changes in the craniocervical posture in children with skeletal class II malocclusion (prognathic mandible) after wearing chincap with lower occlusal bite plane. Methods: the sample consisted of eleven children (7 girls and 4 boys). Three lateral cephalic radiographs were taken for each child with the head in natural position (“mirror position”), with light occlusal contact. The first radiograph (T1) was taken before wearing the chincap, the second (T2) was taken four months after wearing the appliance and the third (T3) was taken four months after removing the chincap. Specific angular and linear dimensions were used, the comparison within the group was performed using Descriptive Analysis and the Normality (Shapiro-Wilk) y Friedman Signed Rank Test. Results: statistical analysis didn’t show significant changes in any of the angular and linear measurements analyzed nor at any of the times studied. Conclusion: even though there is a great individual variability in the cranial, cervical and craniocervical posture of the tested children, in general, there were nostatistical significant changes in cervical posture after treatment with chincap and lower occlusal bite plane.

Study of craniocervical posture and craniofacial morphology in Korean young adults / 대한치과교정학회지

The purpose of this study was to estimate correlations of craniocervical posture and craniofacial morphology in Korean young adults. The sample consisted of 50 young adults (25 males and 25 females) who had good profile and Class I molar relationship. The analysis of craniocervical posture and craniofacial morphology was performed on lateral cephalograms taken in natural head position. The results were as follows; 1. The mean and the standard deviation of postural and morphologic variables were obtained. 2. Korean young adult had cervical lordosis of which degree between OPT and CVT shows 3.55+/-2.58degrees 3. Craniocervical posture and each of vertical ratio, facial prognathism, mandibular rotation showed high correlation. 4. Correlation coefficients between postural variables and each of intermaxillary relation, anteroposterior ratio were low. 5. The head positioning error of natural head position was smaller than the inter-individual variability of postural variables.