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THE IMPLICATION of TMJ MUSCLE in POSTURE RELATION and THEM ,BIOLOGICAL and FUNCTIONAL CORRELATION - Literature Review

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THE IMPLICATION of TMJ MUSCLE in POSTURE RELATION and THEM ,BIOLOGICAL and FUNCTIONAL CORRELATION - Literature Review Romanian Journal of Medical and Dental Education Vol. 8, No. 12, December 2019 THE IMPLICATION OF TMJ MUSCLE IN POSTURE RELATION AND THEM ,BIOLOGICAL AND FUNCTIONAL CORRELATION - literature review Laura Elisabeta Checherita1, Cristina Antohi*2, Ovidiu Stamatin*3 , Stefan Lucian Burlea1 1”Gr.T.Popa”U.M.Ph. – Iasi, Romania, Faculty of Dentistry, DISCIPLINE of Prosthetics 2”Gr.T.Popa”U.M.Ph. – Iasi, Romania, Faculty of Dentistry, DISCIPLINE of Endodontics 3”Gr.T.Popa”U.M.Ph. – Iasi, Romania, Faculty of Dentistry, DISCIPLINE of Oral Implantology 4”Gr.T.Popa”U.M.Ph. – Iasi, Romania, Faculty of Dentistry, DISCIPLINE Of Management Correspondig authors* ;Cristina Antohi: [email protected]; Ovidiu stamatin: [email protected] ABSTRACT The main disorders of the cranio-cervico-mandibular system, which often affect human posture, are the temporomandibular disorders (TMD). These are a group of diseases affecting the muscle of stomatognathic system ,temporomandibular joint, and surrounding structures.Posture refers to the position of the human body and its orientation in space. Posture involves muscle activation that, controlled by the central nervous system ), leads to postural adjustments Postural adjustments are the result of a complex system of mechanisms and nervouse correlation that are controlled by multisensory inputs (visual, vestibular, and somatosensory) integrated in the central nervous system . Keywords : TMJ, muscle , posture relation , rehabilitation , algorithm treatment ,prosthetic . INTRODUCTION ligamentary connections to the cervical region, forming a functional complex called The Stomatognatic system( ssgt ) is a the“cranio-cervico-mandibularsystem.” functional, biological ,integral and integrative The extensive afferent and efferent structure from oral teritory characterized by innervations of the ssgt. are reflected in the several structures: skeletal components extensive representation of the orofacial (maxilla and mandible), dental arches, soft district in the motor and sensory areas of the tissues (salivary glands, nervous and vascular cerebral cortex.[4] supplies), and the temporomandibular joint and masticatory muscles .[1,2,] From literature we revealed that the stomatognathic system also plays an important These structures act in harmony to role in postural control in this context the perform different functional tasks (to speak, to main disorders of the cranio-cervico- break food down into small pieces, and to mandibular system, which often affect human swallow)[3].In particular, the posture, are the temporomandibular disorders temporomandibular joint makes muscular and 45 Romanian Journal of Medical and Dental Education Vol. 8, No. 12, December 2019 (TMD)that include TMJ and also the aferent determine postural tone,and the responsible muscle and also surrounding structures. for maintaining the posture . According to the dento-muscular, The posture is possible thanks to the physiological and psychophysiological interaction between the muscular system and theories, it would seem that the muscles of the skeletal system.[15] stomatognathic system are, in the majority of cases, incriminated in producing the In literature ,from a purely motor dysfunctions of the stomatognathic system . function, the posture can be: - Static: an active resistance to the dislocation In several studies authors indicate that caused by the action of the forces of gravity on different mandibular positions can induce the body segments. variations in body posture. [ 5 ]. For example, - Dinamic: it maintains the balance through the a change in the mandibular position, which can synergistic action of active components (such lead to changes in the proprioceptive and as muscles), passive components (such as periodontal afferents, may affect the center of joints and bones), and control components foot pressure (COP) position and gait (SNC, proprioceptive and exteroceptive stability.[6,7,8] An influence of periodontal systems, vestibular system) (16). receptors on body posture is hypothesized by Gangloff and Perrin (2002),[9] who found a This system is known from studies as significant alteration of postural control after Tonic Postural System, and is a «cybernetic unilateral truncular anesthesia of the system», composed by an afferent system mandibular nerve.[10]. (sensory pathways) that transmits informations to a central computer (Central Nervous Patients with dysfuctional swyndrom System-SNC) that (muscular system) is of stomatognathic system can report bilateral ultimately responsible for postural control or unilateral pain as their primary symptom, thanks to an efferent ,effector pathway . typically triggered by jaw movements or by palpation, where the pain sometimes radiates To simplify the basic mechanism that to the temples or to the neck.[11,12]. regulates the posture, we cou ld refer it to a simple reflex arc, even if, unlike what happens In this context , we can revealed that with the reflexes, the postural movements are posture is an automatic and unconscious continuously influenced and improved by position and it represents the body’s reaction learning and by the exercise. (17) to the gravity force . From gnathologist areal point of wieu Also ,it is maintained through the the main incriminated muscle muscular contraction of skeletal muscles, coordinated by disfunction within the disfunctional syndrome a series of stimuli of various nature and of the stomatognated system is the external through continuous adjustment of pterygoid with both fascicles ,but also the neuromuscular type [13-14]. masseter, tempor al and internal pterygoid. In both static and dynamic balance, the center of gravity is maintained in according to Other muscles associated with anatomic structures but with the minimal dysfunction are considered energy consumption, distributing the body sternocleidomastoid and trapezius. Dawson is weight throughout the skeletal system.The the one who assumes that muscle function authors,also, revealed in 2009 the changes in the presence of occlusal antagonistic isometric contractions that interference, joint obstruction, periodontal 46 Romanian Journal of Medical and Dental Education Vol. 8, No. 12, December 2019 changes, organs that play the role of In the clinical aspects is necessary for proprioceptors of the stomatognathic system. the practitioners for having performs by inspection, palpation and rarely auscultation, in Studies and interest in clarifying this a postural resting position as during active posturology implication and problem have dynamic contraction. Examining the muscles shown that the clinical resonance of of the stomatognathic system will consider the stomatognathic disorders is increasingly following elements: appreciation of muscle moving away from the orofacial sphere to tonicity, the appearance of muscle mass and of spread throughout the body to the foot the bilateral and symmetrical insertions. extremities. In the postural resting position, the In 1971, important authors shows that muscles are characterized by a state of slight there is a direct connection between the oral contraction, for some authors not neuromuscular system and the global electromographically undetectable, which musculature and also there is a parallelism achieves a state of mild tension called postural between occlusal dysfunction, bruxism, muscle tone. Posture tone is variable, impairment of the masticatory muscles and the depending on the clinical, functional, general posture of the body, implicitly of the morphological factors, its assessment must be cephalic extremity that is reveals like the done carefully, depending on the relationships primary responsible factor in the etiology of between the insertional bone segments and the the dysfunctional syndrome of the state of posture tension that the muscle stomatognathic system . [1,2,] develops. [1,2] According to the balance factors For orofacial muscles,in general , the required for homeostasis of the tonicity is appreciated by the simetric right and stomathognated system and the positions in left ,palpation ,of the mobilizing muscles of the genetal from Brodie's scheme, the muscle neighboring regions, of the lips and cheeks, of groups are in a continuous antagonistic balance the tongue. in order to keep the head upright and the mandible resting. The tonicity of the muscles of the lips Some findings are also supported by some and cheeks can be appreciated by the Netter authors who relies on the articles of Rocabado maneuver. The patient may recommend (physiotherapist), stating, among other things, movements (for the mandibule,for the tongue), that 70% of Class II Angle cases have a head to which the practitioner opposes, to test the posture said that head position seems to be contraction capacity of the subject.[forna ]. important and postural modification of the Deviation of the mandibular dynamics from head will cause different bone ratios on the the normal movement trajectories, due to the vertebral assembly. imperative adaptation needed by the interposition of the obstacle, as well as due to The clinical and paraclinical the occurrence of nociceptive reflexes, requires examination of these category of dysfunction the modification of the muscular contraction, patients will necessarily include the assessment both in terms of coordination and resting tone, of physical as well as behavioral, psychosocial capacity resistance to effort. factors. In this context, the aspect of anxiety as Some of the important symtomps an etiological factor of pain and spasm, is caractherising
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