Combined effect of
vestibular and craniomandibular disorders on postural behaviour.
Subject: Combined effect of vestibular and craniomandibular
disorders on postural behaviour.
Monzani D, Guidetti G, Chiarini L, Setti G. Combined effect of
vestibular and craniomandibular disorders on postural behaviour.
Acta Otorhinolaryngol Ital. 2003 Feb;23(1):4-9.
Department of Otorhinolaryngology, University Hospital of Modena
and Reggio Emilia, Modena, Italy. monzani.daniele@unimo.it
A correlation has been reported in the dental literature between
temporomandibular disorders and musculoskeletal abnormalities,
however, the question whether they modify body postural sway remains
controversial. In the present investigation, the Craniomandibular
Index was used to evaluate the clinical extension of temporomandibular
joint dysfunction and related problems in 40 patients with normal
vestibular function and in 42 patients with peripheral vestibular
disorders. Balance function was assessed by static posturography
and body sway area was measured in two conditions: i) eye open,
and g) eye closed. Data were compared to those of 40 healthy subjects.
Postural control showed a significantly different behaviour between
groups with an increase in average body sway in patients with
craniomandibular disorders as opposed to controls (p < 0.005).
Although the involvement of the stomatognathic apparatus was not
quantitatively different in the two groups of patients, those
also presenting a peripheral vestibular disorder exhibited greater
average body sway than patients with only craniomandibular disorders
(p < 0.005). The latter showed a greater average body sway
than controls only in the trial with eyes closed (p < 0.05).
The results demonstrated that craniomandibular alterations could
produce moderate postural instability in patients with a normal
vestibular function. Conversely, their association with peripheral
vestibular disorders becomes a real challenge to the upright quiet
stance probably due to a negative effect of somatosensory origin
on the vestibulo-spinal reflex impairment.
