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the LFS index. This result demonstrates that obtaining a occlusion/muscles/hyoid bone/tongue position is able to
correct functional relationship between tongue, lowering affect the position of the body. From the analysis of the
and elevator muscles of the jaw, occlusal contacts and Romberg index, which as previously stated represents the
hyoid bone lead to a proper head position, which visual interference on postural control, it can be seen that
ultimately affects the position of the body. As a result, in 4 patients an improvement of the LSF corresponds to
after treatment 8 over 10 patients obtained an worsening of the index itself, which shifts towards
improvement of the postural parameter considered in the pathological ranges. Supported by the data found in the
study. In fact, the elevator muscles of the jaw, acting as literature [Bricot, 1999; Guidetti, 1997; Piret, Beziers,
antigravity muscles, maintain the mandibular posture by 1971; Da Cunh et al., 1991] we hypothesised that a
means of the myotactic reflex, which works by activation postural improvement can reveal visual disorders which
of proprioceptive receptors of the same elevator muscles, had been previously masked by the posture [Bricot, 1999].
temporomandibular joint and periodontal receptors In the other patients improvement of the LFS parameters
[Ramfjord, 1969]. However, clinical observations showed and Romberg index overlaps. In these patients the visual
changes in mandibular posture in subjects with intact disorders were of adaptive type, in fact—as evidenced by
trigeminal system [Deriu, 2000]. These data suggest that Guidetti [1996] in his treatise—the nerve fibers of the
control of mandible posture originates also from other oculomotor muscles use the ophthalmic branch of the
nervous structures, which together with the trigeminal trigeminal nerve to reach their respective nuclei. Therefore
structures contribute to the perfect adjustment of the a trigeminal hyperexcitability due to swallowing disorders
mandible position in relation to the position of the head can modulate the nervous control on the oculomotor
and that of the various body segments [Chessa et al., muscles.
1999; Deriu, 2000; Haberfellner, 2005]. Therefore it can
be easily inferred that the systems involved in the control
of posture, and in particular the vestibular labyrinth, affect Conclusion
the elevator muscles of the jaw [Barbato et al., 1996]. Is
has also been observed that patients with vestibular This study, despite the small number of patients but
symptoms may develop disorders of the masticatory supported by the statistic evidence, shows that swallowing
muscles [Guidetti, 1997]. These data support the can modulate postural control and that therefore—
hypothesis that temporomandibular joint, spine, scapular together with the regulation of other receptors—it can be
cingulum and joints in proximal-distal sequence are a determining factor in the treatment of those postural
interdependent [Deriu, 2000]; the postural problems of a syndromes that, if not promptly, may evolve into full-
region do not remain circumscribed to that specific region blown and irreversible musculoskeletal disorders for which
but affect the neighboring segments according to a treatment often proves ineffective. Acknowledgments
postural chain of vertical type [Gelb, 1977; Rocabado, We thank for their cooperation Mrs. Antonina Mura,
1983]. dental hygienist, and Giovanna Senes, registered nurse.
This leads to activation of compensatory mechanisms
aimed to recover and maintain body balance, but the
fatigue of the muscle groups involved in the compensation References
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