Findings of an orthodontic and osteopathic diagnostic of individuals with an asymmetric narrowing of maxilla

Relevance. Postural disorders and their connection to dentofacial abnormalities represent a prominent subject in modern medicine, establishing a new diagnostic standard within the emerging fields of orthodontic and osteopathic diagnostic techniques.

Objective. Establish a correlation between asymmetric narrowing of maxilla and postural disorders in children and teens aged 6 to 15 years. Substantiate the necessity for a combined approach involving both orthodontic and osteopathic diagnostics in this age group, aiming to develop a comprehensive treatment algorithm.

Materials and methods. Orthodontists and an osteopathic physician conducted diagnostic procedures for 320 subjects. Verification methods included standardized questionnaires for orthodontics and osteopathy, digital photography, radiological analysis using cone beam computer tomography (CBCT) of the head, electromyography (EMG), and computer-aided optical postural topography with the DIERS formetric 4D motion system.

Results. Among the 320 subjects examined, the study revealed that 65% presented with an asymmetric narrowing of maxilla. Digital photography illustrated deviations from the norm in the total width of the maxilla for all subjects, a critical factor influencing proper tongue posture, swallowing, and breathing patterns. Facial asymmetry and temporomandibular disorders (TMD) were prevalent among the majority of patients, with a reported mandibular deviation observed in 100% of cases. Based on CBCT data, the transverse dimension of the asymmetrically narrow maxilla, relative to the mid-sagittal axis, was found to be reduced, along with a concomitant displacement of the greater wings of the sphenoid bone. The measured electric activity of masticatory and temporal muscles supported the diagnosis of asymmetric muscular dysfunction. Additionally, irregularities in the sphenobasilar synchondrosis (SBS) were identified. Moreover, patients with asymmetric maxillary narrowing exhibited static and dynamic imbalance in the body, along with disorders of body posture and foot profile. These observations were made through visual assessment, manual testing, and the DIERS formetric 4D motion optical posture topography system.

Conclusion. Asymmetric maxillary narrowing strongly correlated with posture disorders, static and dynamic imbalances in the body, and dysfunctions in primary activities such as chewing, swallowing, breathing, and gait patterns. To achieve a predictable outcome without complications, it is recommended to pursue both orthodontic and osteopathic treatments for cases involving an asymmetric narrowing of maxilla.

1. Kosyreva TF. Biryukov AS. Voeykova OV, Samoylova MV, Gorshunova NV, Rasha A, Gharawi A. Effect of maxillary constriction orthodontic correction using a fixed appliance with a screw in teenagers during a growth spurt. Pediatric dentistry and dental prophylaxis. 2023;23(2):143-152 (In Russ.) doi: 10.33925/1683-3031-2023-564

2. Karpova VS, Polma LV, Bugrovezkaya OG, Persin LS, Uliankina OO, Timinskaya AA. Posture and occlusion. Literatute overview. Ortodontiya. 2012;(4):8-13 (In Russ.). Available from: https://www.elibrary.ru/item.asp?id=22507551&ysclid=lr29rfze8h405726713

3. Di Paolo C, Papi P, Falisi G et al. Subjects with temporomandibular joint disc displacement and body posture assessment via rasterstereography: a pilot case-control study. Eur Rev Med Pharmacol Sci. 2020;24(17):8703-8712. doi: 10.26355/eurrev_202009_22807

4. Segatto E, Segatto A, Braunitzer G, Kirschneck C, Fanghänel J, Danesh G et al. Craniofacial and cervical morphology related to sagittal spinal posture in children and adolescents. Biomed Res Int. 2014;2014:638238. doi: 10.1155/2014/638238

5. Jin C, Wang S, Yang G, Li E, Liang Z. A Review of the Methods on Cobb Angle Measurements for Spinal Curvature. Sensors (Basel). 2022;22(9):3258. doi: 10.3390/s22093258

6. Abdel Raoof NA, Battecha KH, Elsayed SE, Soliman ES. The correlation between radiographic and surface topography assessments in three plane pelvic parameters. J Back Musculoskelet Rehabil. doi: 10.3233/BMR-150444

7. Navarro IJRL, Rosa BND, Candotti CT. Anatomical reference marks, evaluation parameters and reproducibility of surface topography for evaluating the adolescent idiopathic scoliosis: a systematic review with meta-analysis. Gait Posture. 2019;69:112-120. doi: 10.1016/j.gaitpost.2019.01.001