Impact of occlusal stabilization splints on global body posture: a prospective clinical trial

Abstract

Objectives: Body posture of patients with temporomandibular disorders (TMD) has been investigated using different methods, whereas outcome and conclusions were controversial. The present clinical trial aimed to investigate the effects of splint therapy on global body posture.

Materials and methods: 24 subjects (20 females, 4 males; age 24.2 ± 4.0 years) with TMD symptoms were examined clinically (RDC/TMD) and subsequently, splint fabrication was initiated. Along with routine therapy, all subjects underwent three-dimensional pre- and post-treatment full body scans in standing and upright sitting posture using a Vitus Smart XXL 3D scanner. Each scan was acquired in triplicate and evaluated in duplicate, measuring twelve standing and nine sitting postural parameters. Influencing factors were analyzed using analysis of variance (ANOVA), and additional Bland-Altman analyses verified the significance of the ANOVA results.

Results: The increase of Forward Head angles and the decrease of Round Shoulders angles were consistent for both positions and sides. Forward Head angles were significantly influenced by limited mandibular mobility and myofascial pain. Round Shoulders angles showed a significant correlation with myofascial pain, joint noises and the absence of limited mandibular mobility.

Conclusion: The influence of occlusal splints on global posture is limited and only small effects on cervicocranial parameters were found. In the present study, the average head position of post treatment measurements was more centered on the body's core, whereas the shoulders were tilted more anteriorly.

Clinical relevance: Understanding the limited influence of occlusal splints on cervicocranial parameters underscores the need for multimodal treatment strategies for TMD patients.

Keywords: 3D scanning; Body posture; Craniocervical posture; Stabilization splint; Temporomandibular disorders.

Fig. 1

3D-Scan acquired with the Vitus Smart XXL 3D scanner. (a) Forward Head: The angle is formed by the intersection of a line joining the tragus and the spinous process of C7, and a projected line on a Transverse plane at the level of C7. (b) Round Shoulders: The angle is formed by the intersection of a line joining C7 and the acromion, and a projected line on a Transverse plane at the level of the acromion

Fig. 2

Mathematical formula for the calculation of an included angle between a line joining two landmarks and a projected plane at the level of one landmark

Fig. 3

Mathematical formula for the calculation of the side lengths (a, b and c) of the respective triangle. For the calculation of coronal angles, the X coordinates are replaced by Y coordinates

Fig. 4

Mathematical formula for the calculation of the postural angle using the calculated side lengths of the triangle

Fig. 5

All measured angles in the coronal plane before and after splint therapy. White: before splint therapy (T1); Grey: after splint therapy (T2); Without stripes: sitting; Striped: standing; *Highlighted changes were significant and coherent for both sides and positions

Fig. 6

Measured angles of the body core in the sagittal plane before and after splint therapy. White: before splint therapy (T1); Grey: after splint therapy (T2); Without stripes: sitting; Striped: standing; *Highlighted changes were significant and coherent for both sides and positions

Fig. 7

Measured angles of the extremities in the sagittal plane before and after splint therapy. White: before splint therapy (T1); Grey: after splint therapy (T2); Without stripes: sitting; Striped: standing; *Highlighted changes were significant and coherent for both sides and positions