Effect of Occlusal Splints on Posture Balance in Patients with Temporomandibular Joint Disorder: A Prospective Study.

AIM AND OBJECTIVE: Force platforms are widely used to evaluate the relationship between bodily posture and jaw positions. The aim and objective of this clinical prospective study was to evaluate the effect of occlusal splints on bodily posture using force platforms. MATERIALS AND METHODS: Forty-seven female patients with temporomandibular disorders (TMD) underwent a clinical and postural examination before and during an occlusal treatment with an upper splint. Six postural stabilometric examinations were performed under different visual conditions. Postural stability was assessed using a force platform (SATEL). Subjects were evaluated in static and dynamic conditions, with open and closed eyes, at baseline, at 1 week, and at 3 months. Changes in stabilometric parameters (sway area and sway length) were assessed and compared. RESULTS: In static and dynamic positions, the sway surface area decreased significantly after the occlusal guard placement with closed eyes (p-value, 0.012). Likewise, the sway surface area decreased significantly in the dynamic lateral position with closed eyes (p-value, 0.018) and in anteroposterior dynamic position with open eyes (p-value, 0.031). The mean sway length decreased significantly after the placement of the occlusal guard when participants were in the lateral position with open eyes (p-value, 0.025) and in the anteroposterior position with open eyes (p-value, 0.014). On a 3-month assessment, the mean surface and mean length decreased significantly after the placement of the occlusal guard for practically all the static and dynamic positions. CONCLUSION: The sway surface area and sway length decreased significantly with the use of occlusal splints Clinical significance: In female patients with TMD, the use of an occlusal splint is associated with a postural improvement evaluated by posturo-stabilometric tests.

Isokinetic testing of evertor and invertor muscles in patients with chronic ankle instability.

Ankle sprains are among the most common sport-related injuries and can lead to chronic ankle instability. Impaired sensorimotor function of the ankle musculature is often suggested as a cause. The current study sought to assess and compare the isokinetic performance and electromyographic patterns of evertor and invertor muscles in patients with chronic ankle instability and in a control group. Twelve patients with chronic ankle instability and twelve healthy subjects were included. Isokinetic eccentric and concentric testing at various angular velocities was performed for eversion and inversion movements. The corresponding myoelectric activities of the fibularis longus and tibialis anterior muscles were quantified from surface electromyographic recordings by computing average root mean square values. Patients had lower myoelectric activity of the evertor and invertor muscles than controls did; this difference could account for the eccentric weakness associated with ankle instability. Functional strength ratios revealed a dynamic strength imbalance in unstable ankle patients and that may contribute to recurrent injury. Our findings suggest that rehabilitation programs for unstable ankle patients must be focused on the motor control of eccentric contractions of the ankle evertors and invertors, to boost these muscles' contribution to ankle stabilization.