Seiten: 283-294, Sprache: Englisch, DeutschSato, Sadao / Slavicek, Rudolf
Allostasis (dt.: Allostase) ist als eine Reihe von Anpassungsprozessen definiert, die den Körper durch Reaktion auf internen und externen Stress durch das autonome Nervensystem (ANS), die Hypothalamus-Hypophysen- Nebennierenrinden-Achse (HPA-Achse) und das Immunsystem schützen. Allostatische Belastung bezieht sich auf Reaktionen des Körpers, da er gezwungen wird, sich schwierigen psychosozialen oder physikalischen Situationen anzupassen, und deutet auf das Vorhandensein entweder übermäßiger oder erfolgloser Anpassung hin. In den letzten Jahren wurde Beweismaterial dafür gesammelt, dass die Kauaktivität einschließlich des Bruxismus eine wichtige Rolle für die Abschwächung stressinduzierter psychosomatischer Funktionsstörungen durch Downregulation im limbischen System spielt. In diesem Bereich der Forschung spielen zwei Konzepte eine zentrale Rolle: das Konzept des zentral geregelten Regelungsmechanismus und das Konzept der Stress-Bruxismus-Achse. Die Rolle des Kauorgans als Stressabbauventil ist somit als wichtigster Bestandteil zu sehen.
Schlagwörter: Allostase, allostatische Belastung, Homöostase, Kauorgan
Seiten: 295-321, Sprache: Englisch, DeutschStienhans, Christian / Piekartz, Harry von / Knust, Monika
To date, it has not been clearly proven whether there is a direct correlation or no interaction at all between craniomandibular dysfunctions (CMD) and changes in head posture. It was the aim of the present paper to determine whether such a correlation has been described in the literature and whether a particular diagnosis of CMD (primarily arthrogenic, primarily myogenic or mixed forms) shows a significant correlation with changes in head posture. Another objective was to assess the measuring instruments used and in particular to investigate whether the studies specified any quality criteria for measuring instruments (reliability, objectivity, validity). A systematic literature review has been conducted on this basis, yielding 30 studies relevant to the topic, of which 26 were primary studies and four were secondary studies. The evaluation showed that the majority of papers observed a correlation between CMD and changes in head posture. They also found that a mixed diagnosis of CMD, ie, a combination of arthrogenic and myogenic CMD is commonly associated with this change. As there was no adequate information regarding the quality criteria of the measuring instruments used, no ideal measuring instrument could be determined. Currently, the most useful and scientifically substantiated results can be achieved with a combination of cephalometric analyses, inspections, and measurements complemented by clinical tests. More methodologically sound studies would be desirable to prove existing trends and to generate ideal measuring instruments.
Schlagwörter: CMD, head position, head posture, measuring instruments
Open AccessSeiten: 323-338, Sprache: Englisch, DeutschOrdelheide, Alexandra / Bernhardt, Olaf
An overview of national and international publicationsA great variety of splints have been described in the literature but often their effectiveness and mechanisms of action are as yet unclear. The aim of the present paper was therefore to collect and evaluate studies published between 2005 and 2008, in which the effectiveness of different types of occlusal splint therapy for craniomandibular dysfunctions (CMD) was investigated. The literature review was based on the following databases: PubMed, Cochrane Library, and zm-online. A total of six studies were found that matched the search criteria for the effectiveness of occlusal splints for the treatment of CMD. Several studies assumed that it is rarely possible to demonstrate any effects that are attributable to a particular type of splint. In fact, the treatment success is influenced by many factors such as time, patient instruction, the clinician's skills, and a correct diagnosis.
Schlagwörter: centric splint, craniomandibular dysfunction, effectiveness, splint, temporomandibular disorders