Mini-review: Pathways of postural disturbances tracing to the stomatognathic system.

ABSTRACT

Postural alignment is strongly shaped by inborn anatomical and nonvolitional neural factors, whereas postural stability is dynamic in nature and driven by both automatic and volitional sensorimotor processes. The sensory and motor systems responsible for these functions are tightly integrated with the central nervous system, several vital structures of which are in close proximity to the stomatognathic system. Interventions in the oral cavity have therefore been stipulated to provide sensory feedback, which may then be translated into motor function. Since the early 90 s, numerous intervention studies have provided evidence of this correlation, with traditional views advocating that causative factors are mainly indirect. Dynamic postural responses were thus predominantly considered manifestations of head displacement, with most studies identifying potential connections along active and passive muscular interactions. The consideration however, that neuromuscular adaptations of whole-body dynamics might extend beyond biomechanical responses and involve direct pathways as well, has led to a recent paradigm shift, challenging conventional perspectives. Among the suggested pathways are central projections of trigeminal afferents, providing inputs for the oculomotor system, as well as active and passive muscular interactions. Further intervention studies indicate a sensory integration of the stomatognathic system to proprioception, likely through neural networks that work in concert with visual cues and the vestibular organs. Building on this accumulating pool of evidence, a timely perspective is provided on a critical yet underexplored aspect of neurophysiology the intricate interplay between the cranio-cervico-mandibular system and the broader framework of body posture.