Applied Kinesiology and Dentistry – a Narrative Review
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CRANIO® The Journal of Craniomandibular & Sleep Practice ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/ycra20 Applied kinesiology and dentistry – A narrative review Marcello Melis & Massimiliano Di Giosia To cite this article: Marcello Melis & Massimiliano Di Giosia (2020): Applied kinesiology and dentistry – A narrative review, CRANIO®, DOI: 10.1080/08869634.2020.1798669 To link to this article: https://doi.org/10.1080/08869634.2020.1798669 Published online: 28 Jul 2020. Submit your article to this journal View related articles View Crossmark data Full Terms & Conditions of access and use can be found at https://www.tandfonline.com/action/journalInformation?journalCode=ycra20 CRANIO®: THE JOURNAL OF CRANIOMANDIBULAR & SLEEP PRACTICE https://doi.org/10.1080/08869634.2020.1798669 LITERATURE REVIEW Applied kinesiology and dentistry – A narrative review Marcello Melis DMD, Pharm Da and Massimiliano Di Giosia DDSb aPrivate Practice, Cagliari, Italy; Department of Orthodontics, School of Dentistry, University of Cagliari, Cagliari, Italy; bOrofacial Pain Clinic, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA ABSTRACT KEYWORDS Objective: To investigate the use of applied kinesiology in the field of dentistry. Applied kinesiology; muscle Methods: A review of the literature was carried out looking for all articles written on the topic. testing; muscle strength; PubMed, Ovid Medline, and The Cochrane Central Register of Controlled Trials (CENTRAL) data dentistry; dental occlusion; bases were searched. vertical dimension; temporomandibular Results: Only one study was retrieved on the use of applied kinesiology in temporomandibular disorders disorder patients, and only one study was published on dental material testing. A change in muscle strength associated with changes in dental occlusion has been observed in many of the articles selected. Discussion: The use of applied kinesiology for the diagnosis and treatment of pathologies in the field of dentistry is not supported by scientific evidence. However, a relationship between dental occlusion or maxillo-mandibular relationship and isometric muscle strength has been noted. Introduction be a clinically useful tool, but its ultimate scientificvalida tion and application require testing that employs sophis Kinesiology is the study of muscles and their effects on ticated research models in the area of neurophysiology, movements; it is widely used to assess neurologic biomechanics, randomized controlled trials, and statisti integrity. A more specific type of kinesiology is called cal analysis.” However, their study was criticized by Haas “applied kinesiology.” The term refers to a discipline et al. [4], who described many flaws of the article. First, that uses manual muscle testing (MMT) to assess they included in the review trials on MMT used as a variety of body functions [1]. Applied kinesiology a standard orthopedic/neurological test to evaluate mus (AK) evaluates a summation of excitatory and inhibi cle and neurologic integrity, which is very different from tory inputs reaching the motoneurons of the anterior the use of MMT in AK applications. They also carried out horn of the spinal cord by testing the response of a limited review of the literature, excluding from the a particular muscle to resistance applied by a trained study trials showing poor interexaminer reliability [5– professional examiner. A conditionally inhibited 7], insufficient sensitivity and specificity [6–8], and no response is designated as “weak,” and a conditionally test–retest reproducibility [9]. According to the authors, facilitated response is designated as “strong” [2]. when evaluating only MMT as used in AK, excluding the Authors have intended to study alterations in neuro studies where it is used in standard orthopedic/neurolo muscular function in response to physical, chemical, or gical procedures, the limited trials either refute or cannot mental stimuli, usually used in combination with support the validity of AK procedures as diagnostic tests. a standard physical examination with both diagnostic Specifically, MMT for the diagnosis of organic patholo and therapeutic purposes [1,3]. gies or presumed pre/subclinical diseases is not supported A particular type of muscle testing is “therapy loca by scientific evidence [4]. lization” (TL). This is a technique by which any strong Nonetheless, some authors have suggested the use and normally functioning muscle (indicator muscle) of AK in the fieldof dentistry [10–13]. For this reason, will become weak when the patient places his finger on the present review tries to summarize the studies on a specific area to be tested [2]. the topic with the purpose to evaluate whether the use The reliability and validity of MMT have been studied of AK is scientificallysupported and can be suggested by Cuthbert and Goodheart [2] in a review article, where as a diagnostic and therapeutic tool in the field of they concluded that “The MMT employed by chiroprac dentistry. tors, physical therapists, and neurologists was shown to CONTACT Marcello Melis [email protected] Department of Orthodontics, School of Dentistry, University of Cagliari, Selargius, CA 09047, Italy © 2020 Taylor & Francis Group, LLC 2 M. MELIS AND M. DI GIOSIA Materials and methods Several articles, especially the less recent ones, were not clinical trials, rather they represented experts’ opi Literature search nions on the applications of AK in the field of dentistry A literature search was carried out looking for articles [10–17]. Five of them were review articles [1,18–21], on the use of AK in dentistry, including PubMed, Ovid and the rest were clinical trials [22–50]. Most of the Medline, and The Cochrane Central Register of clinical trials included only one group of subjects, who Controlled Trials (CENTRAL) databases. After combin were tested in different conditions (the same subjects ing the different keywords and limiting the search to were used as their own control) [22,23,25–32]. Only two human studies, the titles and abstracts were examined to trials included a placebo [24,25], and only 6 were single- exclude articles not related to the topic. A handsearch of or double-blind studies [24–28,33]. the references of the selected articles was performed The specific topics of AK described in the articles looking for additional papers. An outline of the litera were: 1) application of AK in dentistry; 2) evaluation of ture search is shown in Table 1. dental occlusion; 3) temporomandibular disorders; and 4) dental material testing. They are shown in the respective sections. No trials were identified on therapy localization. Results A total of 23 articles were identifiedon the topic through Application of applied kinesiology in dentistry the database search, and 21 additional papers were found after examining the references. Three of them, Goodheart [11–13], in three papers, promotes the use of which were very old, could not be obtained (Table 1). AK for the evaluation of dental health, especially for the assessment of proper mandibular and temporomandibu lar joint (TMJ) function, by the use of MMT and TL. The Table 1. Literature search. use of MMT was also encouraged by Eversaul [10], espe Searches Keywords Results cially for the determination of correct vertical dimension 1 Applied kinesiology 44,325 Kinesiology of dental occlusion (VDO), and by Glassley [14], to Muscle testing identify TMJ disorders before the occurrence of signs Manual muscle testing Muscle strength and symptoms, to distinguish which TMJ and neuromus Isometric strength cular mechanism is altered, to recognize the necessity of 2 Dentistry 53,7008 Dental preventive procedures in children, to identify cellular Dental occlusion energy deficit and nutritional deficiencies, to establish Temporomandibular joint Temporomandibular joint disorders proper VDO, to detect the degree of TMJ degeneration Temporomandibular disorders and discover whether complete resolution is achievable, Craniomandibular disorders and to comprehend the cause-and-effect relationship TMJ TMD between TMJ pathology and other general health condi CMD tions. Moreover, Nahmani [15] supports the use of AK Myofascial pain Myofascial pain syndrome MMT for the examination of TMJ disorders and dental Myofascial pain dysfunction syndrome occlusion. The only experts’ opinions dismantling the use Face pain Facial pain of AK were written by Schissel [16] and Jakush [17] while Toothache examining the use of alternative medicine in dentistry Tooth pain Tooth pathology and questioning the placebo effect of dental appliances. Tooth cavities In addition, two reviews, by Deogade et al. [1] and Tooth decay Singh et al. [20] promote the use of AK in differentfields Periodontitis Pulpitis of dentistry, such as orthodontics, detection of neural Dental abscess gia-inducing cavitational osteonecrosis (NICO), dental Dental materials Composite resin material tolerance, and temporomandibular disorders Dental composite (TMD). Nonetheless, no evidence was described to sup Dental composite resin Dental amalgam port those hypotheses, and the studies cited do not Amalgam corroborate such suppositions. Mercury amalgam 3 1 AND 2 316 4 Limit to humans 170 5 Title and abstract selection 23 Evaluation of dental occlusion 6 From references 21 7 Unobtainable 3 When specifically looking for AK evaluation of dental 8 Total of articles obtained 41 occlusion by the use of MMT, no clinical trials were CRANIO®: THE JOURNAL OF CRANIOMANDIBULAR