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Dr. Riccardo Riatti - Odontoiatra, Specialista in Ortognatodonzia - Iscr. Ord. Med. Chirurghi ed Odontoiatri RE n° 250 - P.iva 01855640353- Tel. 347. 8685340

Effects of experimental occlusal interference on body posture: an optoelectronic stereophotogrammetric analysis. Marini I, Gatto MR, Bartolucci ML, Bortolotti F, Alessandri Bonetti G, Michelotti A. J Oral Rehabil. 2013 Jul;40(7):509-18.

In recent years, there has been increasing interest in the relationship between dental occlusion and body posture both among people and in scientific literature. The aim of the present longitudinal study is to investigate the effects of an experimental occlusal interference on body posture by means of a force platform and an optoelectronic stereophotogrammetric analysis. An occlusal interference of a 0- to 2-mm-thick glass composite was prepared to disturb the intercuspal position while not creating interference during lateral or protrusive mandibular excursions. Frontal and sagittal kinematic parameters, dynamic gait measurements and superficial electromyographic (SEMG) activity of head and neck muscles were performed on 12 healthy subjects. Measurements were taken 10 days before the application of the occlusal interference, and then immediately before the application, the day after it, and at a distance of 7 and 14 days under four different exteroceptive conditions. The outcomes of this study show that an occlusal interference does not modify significantly over time static and dynamic parameters of body posture under different exteroceptive conditions. It has a minimal influence only on the frontal kinematic parameters related to mandibular position, and it induces a transient increase of the activity of masticatory muscles. In this study, the experimental occlusal interference did not significantly influence the body posture during a 14-day follow-up period.

Dental occlusion, body posture and temporomandibular disorders: where we are now and where we are heading for. Manfredini D, Castroflorio T, Perinetti G, Guarda-Nardini L. J Oral Rehabil. 2012 Jun;39(6):463-71.

The aim of this investigation was to perform a review of the literature dealing with the issue of relationships between dental occlusion, body posture and temporomandibular disorders (TMD). A search of the available literature was performed to determine what the current evidence is regarding: (i) The physiology of the dental occlusion-body posture relationship, (ii) The relationship of these two topics with TMD and (iii) The validity of the available clinical and instrumental devices (surface electromyography, kinesiography and postural platforms) to measure the dental occlusion-body posture-TMD relationship. The available posturographic techniques and devices have not consistently found any association between body posture and dental occlusion. This outcome is most likely due to the many compensation mechanisms occurring within the neuromuscular system regulating body balance. Furthermore, the literature shows that TMD are not often related to specific occlusal conditions, and they also do not have any detectable relationships with head and body posture. The use of clinical and instrumental approaches for assessing body posture is not supported by the wide majority of the literature, mainly because of wide variations in the measurable variables of posture. In conclusion, there is no evidence for the existence of a predictable relationship between occlusal and postural features, and it is clear that the presence of TMD pain is not related with the existence of measurable occluso-postural abnormalities. Therefore, the use instruments and techniques aiming to measure purported occlusal, electromyographic, kinesiographic or posturographic abnormalities cannot be justified in the evidence-based TMD practice.

Changes in root length during orthodontic treatment: advantages for immature teeth . Mavragani M, Bøe OE, Wisth PJ, Selvig KA . Eur J Orthod. 2002 Feb;24(1):91-7.

The purpose of the study was to investigate root lengthening during orthodontic treatment in relation to the age of the patient, the developmental stage of the root, and the anticipated growth. Specifically, the potential benefit of treating young teeth was addressed. The sample consisted of 80 patients.. Additionally, al control group of 66 untreated individuals matched to gender, and pre- and post-treatment age of the experimental group was included. Crown and root lengths of the maxillary incisors were measured on peri-apical radiographs before and after treatment, and corrected for image distortion. Post-treatment root length was significantly related to pre-treatment age. Roots that were incompletely developed before treatment reached a significantly greater length than those that were fully developed at the start of treatment. The results of this study show a definite advantage for younger teeth with regard to post-treatment root length. This finding may influence treatment planning strategy.

A randomized clinical study of two interceptive approaches to palatally displaced canines. Baccetti T, Leonardi M, Armi P. Eur J Orthod. 2008 Aug;30(4):381-5.

This study evaluated the effectiveness of two interceptive approaches to palatally displaced canines (PDC), i.e. extraction of the primary canines alone or in association with the use of a cervical-pull headgear. The randomized prospective design comprised 75 subjects with PDC (92 maxillary canines) who were randomly assigned to three groups: extraction of the primary canine only (EG), extraction of the primary canine and cervical-pull headgear (EHG), and an untreated control group (CG). Panoramic radiographs were evaluated at the time of initial observation (T1) and after an average period of 18 months (T2). The removal of the primary canine as an isolated measure to intercept palatal displacement of maxillary canines showed a success rate of 65 per cent, which was significantly greater than that in the untreated controls (36 per cent). The additional use of a headgear resulted in successful eruption in 87 per cent of the subjects, with a significant improvement in the measurements for intraosseous canine position. The cephalometric superimposition study showed a significant mesial movement of the upper first molars in the CG and EG when compared with the EHG.

Mandibular lip bumper treatment and second molar eruption disturbances. Ferro F, Funiciello G, Perillo L, Chiodini P. Am J Orthod Dentofacial Orthop. 2011 May;139(5):622-627.

INTRODUCTION: Mandibular lip-bumper (LB) nonextraction treatment, usually started before complete second molar (M2) eruption, inevitably interacts with the development of the dentition. Yet, its effects on M2 eruption are still unknown. The first aim of this study was to retrospectively investigate whether LB therapy (260 patients) enhances the risk for M2 ectopic eruptions and impactions in comparison with 135 untreated subjects. The second aim was to assess, among treated patients (n = 197), the main potential determinants of M2 impaction and ectopic eruption. METHODS: M2 eruption and impaction were determined on panoramic radiographs. To assess the predictive role of M2 inclination in relation to the first molar, a panoramic radiograph suitable for this measurement before treatment was required. RESULTS: LB treatment significantly enhanced M2 impaction and ectopic eruption. Negative prognostic factors were found. An initial inclination of the M2 greater than 30° was significantly associated with a higher impaction risk compared with an angulation less than 10°. LB treatment duration longer than 2 years increased the risk of ectopic eruptions. CONCLUSIONS: While gaining space in the anterior arch, unwanted effects might be produced in the posterior arch. To be informed about these unplanned events is necessary to better optimize treatment.

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Interventions for treating asymptomatic impacted wisdom teeth in adolescents and adults. Mettes TG, Nienhuijs ME, van der Sanden WJ, Verdonschot EH, Plasschaert AJ. Cochrane Database Syst Rev. 2005 Apr 18;(2).

BACKGROUND:The prophylactic removal of asymptomatic impacted wisdom teeth is defined as the (surgical) removal of wisdom teeth in the absence of local disease. Impacted wisdom teeth have been associated with pathological changes, such as inflammation of the gums around the tooth, root resorption, gums- and alveolar bone disease, damage of the adjacent teeth, the development of cysts and tumours. Several other reasons to justify prophylactic removal have also been given. Wisdom teeth do not always fulfil a functional role in the mouth. When surgical removal is carried out in older patients the risk of more postoperative complications, pain and discomfort increases. Nevertheless, in most developed countries the prophylactic removal of trouble-free wisdom teeth, either impacted or fully erupted, has long been considered as 'appropriate care'. Prudent decision-making, with adherence to specified indicators for removal, may reduce the number of surgical procedures by 60% or more. It has been suggested that watchful monitoring of asymptomatic wisdom teeth may be an appropriate strategy. OBJECTIVES: To evaluate the effect of prophylactic removal of asymptomatic impacted wisdom teeth in adolescents and adults compared with the retention of these wisdom teeth. AUTHORS' CONCLUSIONS: No evidence was found to support or refute routine prophylactic removal of asymptomatic impacted wisdom teeth in adults. There is some reliable evidence that suggests that the prophylactic removal of asymptomatic impacted wisdom teeth in adolescents neither reduces nor prevents late incisor crowding.