Pages 97-101, Language: English, GermanHugger, Alfons / Kordaß, Bernd / Lange, Matthias / Ahlers, M. Oliver
The German Agency for Health Technology Assessment (HTA) of the DIMDI (German Institute of Medical Documentation and Information) recently published its HTA report on "Dental indications for standardised procedures of instrumental functional analysis under consideration of health economic aspects"a (Report 101). The authors' aim was to evaluate "the currently available evidence of the instrumental functional analysis as diagnostic procedures [sic] for craniomandibular or temporomandibular dysfunctions in comparison to the classic clinical functional analysis"a. The report thus claimed that the included statements should be viewed within the context of healthcare policy-or that the report may even be capable of giving counsel or directions on health policy.
Pages 103-131, Language: English, GermanKuklinski, Peter-Paul / Lampe, Renée / Stuckrad, Ute M. v. / Benz, Christoph R. V. / Haffner, Cornelius
Objective: To look for correlations between occlusal patterns and posture disorders in a group of children with cerebral palsy (CP).
Materials and methods: 117 (93) representative children (12 years ± 5 years) were examined for dental, occlusal (117) and orthopedic (93) findings. The oral results were compared with a control group (6-12 years, > 12 years) and the correlations between posture disorders and occlusal findings were evaluated statistically (Chi square).
Results: A gender-matched sample (64 male, 53 female) was divided into three groups (3-6 years, 6-12 years, >12 years) and did not show any significant differences in occlusal findings in comparison to the control group, with the exception of the anterior open bite. Significant correlations between posture and occlusal patterns could not be detected, although for all 93 children marked posture disorders were diagnosed.
Conclusions: The occlusal findings did not correlate to posture and children with CP have no higher risk for orthodontic diseases.
Keywords: cerebral palsy, occlusal patterns, posture
Pages 115-126, Language: English, GermanMueller, Cornelia Katharina / Mueller, Andrea / Schultze-Mosgau, Stefan
Objective: A pathophysiologic link between malocclusions and temporomandibular disorders (TMD) is still being debated. This study correlates pain, joint sounds, and limited opening with a subset of orthodontic findings in different age groups.
Patients and methods: A case-control study employing 697 patients was conducted. Patients were subdivided into three age groups: 1 (n = 297): 7-12 years; 2 (n = 302): 13-18 years; 3 (n = 98): > 18 years. Orthodontic and TMD diagnostics were performed. A multivariate logistic regression approach was used to correlate malocclusions with TMD.
Results: A correlation between mandibular skeletal midline deviation and joint/muscle pain was found in group 1 (P < 0.001), 2 (P < 0.001) and 3 (P = 0.008). Furthermore, mandibular skeletal midline deviation was an independent predictor of joint sounds (P = 0.009) and limited opening (P = 0.014) in group 3.
Conclusion: Further longitudinal studies employing a group of patients with orthodontic treatment and a control group without treatment are needed to verify the potential of TMD prevention by early treatment for lateral force bite.
Keywords: malocclusion, multivariate analysis, temporomandibular disorders
Pages 131-140, Language: English, GermanChetta, Giovanni / Crescente, Melchiorre
Die Ergebnisse einer integrierten Herangehensweise an einen Fall mit komplexem und behinderndem Haltungsschaden illustriert die Wichtigkeit der Teamarbeit in der Posturologie. Bei korrekter Auffassung der menschlichen Biomechanik verhält sich der Körper als Vortex entlang einer Transversalebene und (an den Füßen) einer Frontalebene. Wir Menschen, als einzige Zweibeiner unter den Säugetieren, können uns dank dieser Tensegrität mit ihren inneren Vernetzungen höchst effektiv im Feld der Schwerkraft bewegen. Der Mensch als ultimatives kybernetisches System muss die ihn umgebende Umwelt jederzeit fühlen können. Aufgrund der wesentlichen Veränderungen, welche die moderne Gesellschaft dieser Umwelt auferlegt hat, wird Ergonomie zum integralen und wesentlichen Bestandteil einer Haltungsrehabilitation. Gut gestützte Fußsohlen und Bissverhältnisse sind für die Körperhaltung offenbar wesentlich. Ergonomische Hilfsmittel wie Aufbissschienen und Einlegesohlen (in synergistischer Weise ergänzt durch Techniken zur Beeinflussung des myofaszialen Systems) könnten somit zu wichtigen Resultaten führen. Wie die vorliegende Fallstudie zeigt, können sich diese Resultate mit Messinstrumenten nachweisen und quantifizieren lassen.
Keywords: Körperarbeit, Nackenschmerzen, Ergonomie, Gymnastik, Einlegesohlen, Haltungsanalyse, Haltungsrehabilitation, Migräne, Skoliose