CRANIO®

The Journal of Craniomandibular & Sleep Practice

ISSN: 0886-9634 (Print) 2151-0903 (Online) Journal homepage: http://www.tandfonline.com/loi/ycra20

Relationship Between Dental Occlusion and

Posture

Ramin Sharifi Milani D.S.O., Dominique Deville De Perière Ph.D., Luc Lapeyre
D.S.S. & Laurence Pourreyron D.S.S.

To cite this article: Ramin Sharifi Milani D.S.O., Dominique Deville De Perière Ph.D., Luc
Lapeyre D.S.S. & Laurence Pourreyron D.S.S. (2000) Relationship Between Dental Occlusion and
Posture, CRANIO®, 18:2, 127-134, DOI: 10.1080/08869634.2000.11746124

To link to this article: http://dx.doi.org/10.1080/08869634.2000.11746124

Published online: 13 Jul 2016.

Submit your article to this journal

Article views: 2

View related articles

Citing articles: 13 View citing articles

Full Terms & Conditions of access and use can be found at

http://www.tandfonline.com/action/journalInformation?journalCode=ycra20

Download by: [Cornell University Library] Date: 15 October 2016, At: 10:46

0886-9634/1802-
127$05.00/0, THE
JOURNAL OF
CRANIOMANDIBULAR
PRACTICE,
Copyright© 2000
by CHROMA, lnc.
Manuscript received
October 14, 1999; revised
manuscript received
February 15, 2000; accepted
February 15, 2000
Dr. Ramin Sharifi Milani
7 Place Alexandre Laissac
34000 Montpellier
France
• OCCLUSION
Relationship Between Dental Occlusion and Posture
Ramin Sharifi Milani, D.S.O.; Dominique Deville De Perière, Ph.D.;
Luc Lapeyre, D.S.S.; Laurence Pourreyron, D.S.S.
ABSTRACT: The purpose of this study is ta show the effects of dental occlusion on postural position.
Thirty subjects were divided into two groups: an experimental group who wore mandibular orthopedie
repositioning appliances (MORA) and a control group who wore no oral deviee. Ali of the subjects under-
went the same Fukuda-Unterberger experimental stepping test ta check their postural attitude. Any devi-
ation of the subject during the test from his initial position was analyzed. The results seemed ta confirm
that altering dental occlusion by wearing an oral appliance could induce sorne fluctuations in dynamic
postural attitude. The phenomenon occurs after prolonged wearing of a MORA. Feedback effects are
graduai after removing the mandibular splint.
entai occlusion has long been and still is a very
Dr. Ramin Sharifi Milani is a doctor of
odontology teaching on thefaculty of the
University of Odontology, Montpellier,
France, in the Department of Conserv-
D controversial field in dentistry. Much of the con-
flicting ideas about occlusion are based more on
belief than on evidence so new research is welcomed in
ative Dentistry. The primary focus of his this area.
work is the relationship between posture
It has been understood for a long time that dental
and dental occlusion.
occlusion goes beyond the scope of teeth contacts. In
the sports world sorne view the use of splints to be
governed solely by the etiology of temporomandibular
joint (TMJ) pathology and leave diagnosis to oral sur-
Dr. Dominique Deville de Perière is the geons and dentists; others provide sports participants
Dean of the faculty of the University of with free occlusal splints. Between gadget and placebo
Odontology, Montpellier, France, and is
effect, where is the truth?
the head of the Physiology Department.
She is a member of the CED, IADR The far-reaching effects of modifying dental occlusion
Division. She has published papers on on the muscular system were considered a taboo for
submandibular salivary glands, diabetes,
odontologists for many years. Many researchers have
and insulin peptide.
tried to prove there are side effects through the use of dif-
ferent gauging appliances and different techniques of
manipulation. Opponents of this type of analysis have for
Dr. Luc Lapeyre is the Vice-dean of the a long time criticized this methodology, because it is pre-
faculty of the University of Odontology, dominantly based on the answers to questionnaires and to
Montpellier, France, and is also the head a person's subjective analysis.
of the Conservative Dentistry and
Endodontics Department. He has pub- Today, the part played by teeth in orofacial balance
lished various articles on EEG of the and on muscular mastication is widely recognized. Dental
pterygoids. Dr. Lapeyre dedicates his time
contact becomes the visible and tangible expression of
to analysis of and research into artificial
saliva. the muscular, articular, neurological, and psychological
behavior of the patient.
127
EFFECTS OF OCCLUSION ON POSTURE
Terms such as MORA (mandibular orthopedie reposi-
tioning appliance), TMDs (temporomandibular disor-
ders), and many others are now an everyday part of
physicians' and physiologists' vocabulary. This in and of
itself proves that, more than ever before, the medical
community is becoming aware of the need for medical
practice to be undertaken with multidisciplinary team-
work. Therefore, occlusion becomes a total concept, and
the patient becomes an invalid. The clinical approach
becomes very complex, and the therapeutics are numer-
ous. The complex nature of the human body demands that
illnesses no longer be reduced to the mere context of their
anatomicallocation.
The influence on dental occlusion by the masticatory
muscle system has been widely studied and discussed in
the study of human posture.
At first studies showed the relationship between dental
occlusion and masticatory muscle equilibrium. 1- 3 The
effects of occlusion on head posture have been studied
and proven. 4 •5 Many au thors like Check6 in 1988 have
studied myofascial pain syndrome in regard to dental
occlusion. Still others like Aloi, 7 Bakke, 8 Huggare and
Raustia, 9 Tripodakis, 10 and Smith 11 attempted to establish
the effects of dental occlusion on human body functions.
Nonsupporters of this idea biarne the researchers for
basing their methodology on subjective analysis and for
being unaware of placebo effects.
We know that sorne athletes use MORAto improve
their athletic performances. Since the Academy of Sports
Dentistry was chartered in 1983, there has been a surge
in research into performance modification, most of
which deals with the use of splints. However, ali studies
do not agree. 12•13
The purpose of this study was to try to objectively
show a link between dental occlusion and general muscle
structure, particularly the muscles responsible for pos-
tural activity. Hence, the hypothesis: An improvement in
imperfect dental occlusion tends to remedy a postural
defect. In this study, we attempted to physiologically
verify the works of Meyer and Baron 14 with regard to
the participation of trigeminal relations in postural
regulation.
Dental occlusion is understood to mean the inter-dental
links for which normalities have been established.
Pathological variations can take place. We report on our
experiments on 15 subjects who wore an occlusal reposi-
tioning splint for four weeks and compare them with a
control group of the same number of subjects who wore
no oral deviee. The two groups were subjected to postural
attitude tests. The experiments consisted of qualitatively
testing the labyrinthine (see Figure 1) oculo-cephalic
function of 30 subjects, using a Fukuda-Unterberger test.
128 THE JOURNAL OF CRANIOMANDIBULAR PRACTICE
SHARIFI MILANI ET AL.
Then, using occlusal repositioning appliances, we
attempted to provoke a change in the occlusal attitude of
15 subjects and examined the effects on their posture.
Materials and Methods
Fukuda-Unterberger Testsl5-16
A test was designed and performed by Unterberger in
1938 and completed by Fukuda in 1958 at Gifu, Japan.
The test consists of making a subject walk on a prescribed
line, barefooted, eyes closed and arms straight. Each sub-
ject walks fifty paces with his feet lifting up to knee level.
The walking rhythm is at 1.2-1.4 Hz (Figure 1).
In our study, the test was done in a room specially pre-
pared with landmarks for the test. For the test, it must be
absolutely quiet and dark without no exterior interfer-
ence. The subject stands with his/her eyes closed and the
examiner traces the contour of his/her steps using the
position of the heel on the floor, the "polygon of susten-
tation" and its vertical (we cali polygon of sustentation,
an area limited by the feet. The center of gravity is pro-
jected to be the center of this area). After 50 steps, the
examiner designs the new polygon of sustentation of the
subject who has tried to walk without any displacement
from the line. With the help of a goniometer, the exam-
iner measures the angle of rotation of the subject.
For convenience and understanding for ali the subjects,
we decided that the displacement on the right side is
distinguished by (+), on the left side by (-). Advancement
or recoil of subjects was not considered in this paper. In
this way the deviation of the subject with regard to his
initial position is measured by the degree of the angle
of rotation.
The validity of this test has already been proven. 17 The
stepping test explores the labyrinthine, oculo-cephalic
skill of the subject. lt consists of noting the movements of
the patient's hands (stretched in front of him) as weil as
his direction as he takes fifty steps with his eyes closed.
Fukuda believes that: "Decrease in postrotatory nystag-
mus due to repeated rotations cannot be explained by
fatigue, damage or paresis but it should be understood as
an improvement of the labyrinthine equilibrating func-
tion as evidenced by the establishment of the kinetic
labyrinthine function." This test allowed us to observe the
effect of wearing an occlusal splint on the proprioceptive
functions of the subject. Since we noted during our exper-
iment a certain adaptation of the patients to this test, we
avoided carrying out more than two consecutive tests.
Population Study
The test was carried out on 30 subjects selected at
random. The subjects were divided in two groups. The
APRIL 2000, VOL. 18, NO. 2
SHARIFI MILANI ET AL.
Figure 1
The Fukuda-Unterberger stepping test consists of making a subject walk on the spot, barefooted, eyes closed and arms straight. Each subject walks
50 paces with his feet lifting up to knee leve!. The walking rhythm is at 1.2-1.4 Hz. The deviation of the subject with regard to his initial position is
measured by the degree of the angle of rotation.
first group, the control group, was subjected to the pro-
posed tests having never wom a splint. The second group,
the experimental group, wore splints. The age of the sub-
ject, the day, and the precise time of the examination
were all noted.
The average age was 31.5 years old (+9.5, -15.5 years).
There were 22 male subjects (73%) and eight female sub-
jects (27% ). The subjects were chosen from among the
regular membership of a multi-sports club.
A dental examination was done prior to the experi-
ment: 14 subjects were in dental class I (neutrocclusion),
seven of whom were included in the experimental group;
nine subjects were in dental class TI or distocclusion (two
subjects in class II-a, five subjects in class II-b), six of
whom were included in the experimental group; and
seven subjects were in dental class III (mesiocclusion),
two of whom were included in the experimental group.
Two subjects presented serious dentodental dishar-
monies. One of these subjects bad three decayed teeth.
There were no dental treatrnents done during the period
of the experiment. Six subjects in the experimental group
bad rnissing molars. The occlusal deviee used filled these
toothless sectors.
APRIL 2000, VOL. 18, NO. 2
EFFECTS OF OCCLUSION ON POSTURE
Assembly of the Occlusal Repositioning Deviee
The splint permits prevention of intercuspation of the
arches by interposing a prosthetic deviee which is des-
tined to allow the mandible to adopt a new and more
stable position, thus creating muscular and articular equi-
librium. It can also be used to create an immediate modi-
fication of the occlusion. 18
With the splint we expected the following results:
1. To modify the sensorial and tactile influx of the teeth
by rationally and physiologically distributing the
forces on the teeth in harmony with a physiological
condylar position.
2. The modification would not permanent.
3. To allow the completion of the arches on the edentu-
lous sectors.
4. To provoke the loss of neuromuscular me mory,
thereby inducing a loosening of muscular tension
and to bring about the end of spasms and contrac-
tions.
An electromyographic (EMG) analysis of the mastica-
tion muscles underscored a reduction of muscular hyper-
tonia and the relief of painful symptoms by neutralizing
traumatic forces exerted on the joints.l9,2o
THE JOURNAL OF CRANIOMANDIBULAR PRACTICE 129
EFFECTS OF OCCLUSION ON POSTURE
The splint used had a smooth surface and there were no
interferences at the time of mandibular movements. lt
was adjusted on all the occlusal surfaces of the mandibu-
lar teeth. This splint was molded in resin around the
crown level in the interproximal zones of the teeth.
Moreover, it covered the whole of the lingual and vestibu-
lar aspects of the teeth.
After taking dental impressions of the individual's
mouth, the impression was transformed into hard plaster
and then into resin by a dental prosthetics laboratory.
Centric relation and centric occlusion were studied for
all of the subjects. Centric relation was taken into consid-
eration when assembling the occlusal appliance. The
splint was worn at least 12 hours per day (during sleep
and also during any physical sport activity). The subjects
were allowed to remove their splints for meals.
Five series of tests were carried out. One on day 0, then
on day 7, day 14 and then 21 days after first wearing the
splint. AU tests were carried out under the same condi-
tions as the first test. Finally, after 28 days, one week
after removing the splint, the tests were repeated. No
information on the results of the examination was given
to the subjects to avoid causing auto-reeducation.
Statistical Data
The results of this experiment were processed with the
help of a statistical program called STAT-ITCF (UFR
STAPS, 700 Av. Pic StLoup 34090Montpellier, France).
The statistical analyses were performed using analysis of
variance. The overall number of observations was 90
(comparison between control group and experimental
group, each with 45 observations). The studied factors
were a group factor on two levels along with a time factor
on three levels. The interaction between group/time was
studied using a Newman-Keuls test.
Results
The control group results showed that the Fukuda-
Unterberger stepping test is reliable and reproducible at
87% (13 subjects out of 15 tested after 7th day's tests)
taking into account the sense of rotation of subjects.
In the experimental group, the results obtained are
shown in Figures 2 and 3. On Day 7: 73% of cases
(eleven subjects out of 15 tested) had a modified angle
of rotation (absolute average progression was 22.5
degrees). On Day 14: 93% of cases (14 subjects out of 15
tested) bad the angle of rotation modified (absolute aver-
age progression = 36.3 degrees). On Day 21: also 93%
with angle of rotation modified, however the absolute
average progression was 39.2 degrees. Finally, 14
130 THE JOURNAL OF CRANIOMANDIBULAR PRACTICE
SHARIFI MILANI ET AL.
subjects showing an improvement in postural attitude on
day 21 were asked back to take the tests again, seven days
after removal of the splint (Day 28). A return to pre-
experimental normality was noted in eight subjects
(57%), while the other six subjects showed levels identi-
cal to day 21. The feedback effects are graduai and will
take sorne time (Figure 4).
The statistical tests show that the results are significant
based on the Fukuda-Unterberger test when considering
the interaction between "group factor" and the "time
factor." The comparison between the experimental group
and the control group did not show a strong probability of
being affected by the occlusal appliance (p =.28), nor for
a "time of wearing" effect (p = .13). The analyses of
group/time interaction showed a weak probability of the
effects of occlusal splint (p = .03). These statistical results
were confirmed using a Newman-Keuls test for the corre-
lation between "group factor" and "time of wearing
factor" (p = .03).
Nonetheless, looking at the results, we observed a
very slight variation on the seventh day. The greatest pro-
gression was observed on day 21; however, the most
improvements were obtained after two weeks of wearing
the splint.
In the experimental group, we have noted that:
1. All of our subjects easily tolerated wearing the
splint; and
2. Three subjects bad strong feelings of improvement,
particularly in the neck and masticatory musculature.
Twenty-seven percent of the subjects also believed that
their athletic performances were improved by wearing
the splints.
Discussion
This study allows us to present the role occlusion plays
in posture through observance of its influence on the par-
ticipants' labyrinthine activity, which is one of the key
elements of equilibrium, and posture. The results obtained
in the study unquestionably show the effects of an occlusal
modification on labyrinthine activity (brought on by
wearing a splint). Efforts were undertaken to minirnize
any artificial effect, so that wearing the occlusal splint
was the sole effect.
W e insisted on using the term variation rather than
improvement simply because the objective of the study
was to prove that there is a link between dental occlusion
and posture (through the intermediary of labyrinthine
proprioception). An attempt at improvement would
necessitate a broader study of the postural and mastica-
tory attitudes of the subject which would require a longer
term study.
APRIL 2000, VOL. 18, NO. 2
SHARIFI MILANI ET AL. EFFECTS OF OCCLUSION ON POSTURE

ANGLE OF ROTATION

Figure 2 (above) and Figure 3 (below)

Fukuda tests: The results are expressed in the amounts witb regard to the angle of rotation of the subjects (+) if the rotation is to the right, (-) if the
rotation is to the left. The variation of the angle of rotation must be considered for each subject separately. The experimental group (Figure 2 above)
shows a serrated form when compared with the control group (Figure 3 below).

ANGLE OF ROTATION

APRIL 2000, VOL. 18, NO. 2 THE JOURNAL OF CRANIOMANDIBULAR PRACTICE 131
EFFECTS OF OCCLUSION ON POSTURE SHARIFI MILANI ET AL.

WEEKS

Figure4
Represents the average progression of results of four measurements taken following the initial measurement. Based upon the initial measurement to
be at Day 0 at (0) and taking the absolute value of the measurements, one can see the progression for each subject (experimental group) while wear-
ing an occlusal appliance for three weeks. One week after removing the appliance, the final test showed a return to pre-experimental norrnality.

We consider most of the negative results as variations
in the context of our study. We could have been tempted
at the start to expect immediate effects from the splint.
However, the first effects did not appear until after a few
days. It would be interesting to find out the number of
hours necessary for the very frrst effects to appear.
The statistical tests using analysis of variance confirm
the reliability of the Unterberger-Fukuda test. Our results
showed no significant evolution between day 0 and day
+21 in the control group. However, this analysis con-
firmed by a Newman-Keuls test, showed the changes of
angle of rotation in the experimental group in a progres-
sive manner from day 0 to day +21 (Figure 4). The only
modification introduced was for the individuals in the
experimental group to wear an interocclusal splint.
In the results (see Appendix page 134), we have to
admit to a certain conditioning of the subjects to experi-
mentation conditions. Indeed, as we have previously
pointed out, it is inadvisable to use this test more than
twice consecutively, especially at the same place of
experimentation. This allows the subject to avoid placing
himself in the space, in relation to the diverse markers.
What is interesting to observe is the effect of the splint
on subjects with dentomaxillary disharmonies: they were
more responsive to the wearing of an occlusal deviee and
the corrections were more spectacular (in four subjects).
Finally, the return to pre-experimental postural attitude
also takes place progressively; further tests on day 28
showed a regression of the variations which had been
provoked but no immediate disappearance of them. The
proprioception of the oral sphere would necessitate there-
fore a certain period of refitting (Figure 4).
These results are comparable to those found in the lit-
erature, i.e., Bakke, 8 Grunert, 19 and Williamson20 have set
themselves the task of finding the effects of occlusion on
orofacial musculature, particularly through electromyog-
raphy. Asymmetry of function, between the two facial
sides and in the case of malocclusion, has been previ-
ously reported.
Other studies have gone further: Throckmorton, 21 but
more especially, Gole22 who carried out a study on 44
subjects, where he found 38 cases of interaction between
the denture and the musculature at a distance from the
masticatory musculature.

132 THE JOURNAL OF CRANIOMANDIBULAR PRACTICE APRIL 2000, VOL. 18, NO. 2
SHARIFI MILANI ET AL.
Meyer and Baron14 seem to be the first ones interested
in the posture/vision/teeth relationship, based on their
study done on two marksmen. They showed that a peri-
odontal, masticatory, and non-nociceptive agitation can
be responsible for focusing problems in the treated
subjects. It is important to note that they used a
Statokinesimeter to record the postural orthostatic activ-
ity of the subjects.
A second study by the same authors, 23 on the participa-
tion of trigeminal afferences in the postural tonie regula-
tion where they used the Fukuda-Unterberger test finds
the same results. In both cases, any modifications to the
oral sphere creates variations in the posture of the subject.
Finally in confirmation of our hypothesis, a recently
published article24 shows that wearing an occlusal splint
can objectively induce certain modifications in the visual
focusing of subjects. We know that visual focusing is one
of the essential elements of human posture, just as are the
spine, feet, and sensorial receptors.
Conclusions
We noted that wearing an occlusal splint allows certain
subjects to objectively modify their postural attitude. The
effect does not appear immediate!y but requires a certain
period of muscular adaptation. The disappearance of neu-
rosensorial memory is progressive and does not appear
until severa! days of wearing the splint. We also noted
that the splint is most efficient after two weeks of wear.
The changes are less spectacular during the third week.
The removal of the splint inhibits the effects obtained
and causes a return to the position of occlusion and of ini-
tial postural attitude. The subjective effects of physical
improvement based on wearing an oral deviee are spec-
tacular, but the difference between the subjective effects
and the placebo effect is yet to be determined. However,
it should not be thought that ali occlusal disorders have
repercussions on posture. In the same way, a postural
defect should frrst raise the question as to the function of
the postural system.
We have tried to prove that dental occlusion modifica-
tion can have effects elsewhere on the individual. These
effects can manifest themselves in a change in the pos-
tural attitude of the subject. These results show that it is
possible, by modifying dental occlusion, to modify the
dynamic postural attitude of the subject by intervening in
his proprioception skills.
It is very difficult to determine which of the senses
may have an influence on human posture by means of a
dental occlusion modification. W e can only see one
reason for the effect. Even if we let ourselves believe in
the effects that occlusion has on the entire individual
APRIL 2000, VOL. 18, NO. 2
EFFECTS OF OCCLUSION ON POSTURE
which have been clinically tested and reported, we must
do further research and studies for final proof of a sensory
tract explaining these effects.
References
1. Abekura H, Kotani H, Tokuyama H, Hamada T: Asymmetry of masticatory
muscle activity during maximal clenching in healthy subjects and subjects
with stomatognathic dysfunction syndrome. J Oral Rehabil 1995;
22(9):699-704.
2. Clark GT, Browne P, Nakano M, Yang Q: Co-activation of stemocleidomas-
toid muscles during maximum clenching. J Dent Res 1993; 72(11):1499-
1502.
3. Kiliaridis S, Katsaros C, Karlsson S: Effect of masticatory muscle fatigue on
cranio vertical head posture and rest position of the mandible. Eur J Oral
Sei 1995; 103(3): 127-132.
4. Lee W, Okeson J, Lindroth J: The relationship between forwardhead posture
and temporomandibular disorders. J Orofac Pain 1995; 9(2):161-167.
5. Sandikcioglu M, Skov S, Solow B: Atlas morphology in relation to craniofa-
cial and head posture. Eur J Orthod 1994; 16(2):96-103.
6. CheckRK, Carlson GL, FrictonJR: ReportoftheAdHoc Committee on cran-
iomandibular and temporomandibular joint disorders: current concepts of
diagnosis and treatment. Minnesota Dental Association, 1988.
7. Aloi A: Effects of mandibular appliances on athletic performance. Cranio
Clin /nt 1991; 1(2): 99-105.
8. Bakke M: Mandibular elevator muscles: physiology, action and effect of
dental occlusion. Scand J Dent Res 1993; 101(5):314-331.
9. Huggare J, Raustia A: Head posture and cervicovertebral and craniofacial
morphology in patients with craniomandibular dysfunction. J Craniomandib
Pract 1992; 10(3):173-177.
10. Tripodakis AP, Smulow JB, Mehta NR, Clark RE: Clinical study of location
and reproducibility of three mandibular positions in relation to body pos-
ture and muscle function. J Prosthet Dent 1995; 73(2): 190-198.
Il. Smith SD: Muscular strength correlated to jaw posture and the temporo-
mandibular joint. NY State Dent J 1978; 44:279-282.
12. Verban EM: A biochemical analysis of the effects of a mandibular orthopedie
repositioning appliance on shoulder strength. J Craniomandib Pract 1984;
2:232-237.
13. Valdivia J, Manns A, Miralles R: Myofascial pain dysfunction syndrome:
comparative clinical evaluation of the therapeutic basis of three appliance
designs. Chilean Orthodontie Review 1985; 2:108-116.
14. Meyer J, Baron JB: Participation of trigeminal afferences in tonie postural
regulation. Static and dynarnic aspects. Agressiologie 1976; 17(A): 33-40.
15. Fukuda T, Hinoki M, Tokita T: Functional development oflabyrinthine func-
tion with rotatory training. Acta Oto-Laryngologica 1958; 49:467-477.
16. Unterberger S: Neue objective registrierbare vestibularis drehereaktion,
erhalten durch treten auf der stelle. Der ''Tretversuch." Arch Klin Exp Ohr
Nas Kehlokp 1938;145:478-480.
17. Norre ME, Peeraer L, V andebeck E: The stepping test evaluated by recording
technique. Agressiologie 1979; 20(B):127-128.
18. Clark GT: A critical evaluation of orthopedie interocclusal appliance therapy,
design, theory and overall effectiveness. fADA 1984; 108(33):359-363.
19. Grunert I, Kofler M, Gausch K, Kronenberg M: Masseter and temporalis sur-
face electromyography in patients wearing complete dentures comparing
anterior and posterior occlusal concepts; a pilot study. J Oral Rehabill994;
21(3):337-347.
20. Williamson EH, Navarro EZ, Zwemer JD: A comparison of electromyo-
graphic activity between anterior repositioning splint therapy and a centric
relation splint. J Craniomandib Pract 1993; 11(3):178-183.
21. Throckmorton GS, Dean JS: The relationship betweenjaw-muscle mechani-
cal advantage and activity levels during isometric bites in humans. Arch
Oral Bioll994; 39(5):429-437.
22. Gole DR: A clinical observation: a relationship of occlusal contacts to distal
musculature. J Craniomandib Pract 1993; 11(1):55-61.
23. Meyer J, Baron JB: Orthostatic posture relations- markmen's masticatory
system. Symbioses 1979; 9(3):169-183.
24. Milani RS, Deville de Perière D, Micallef JP: Relationship between dental
occlusion and visual focusing. J Craniomandib Pract 1998, 16(2):109-118.
Dr. Laurence Pourreyron is the head of the Prosthetic Department of
the faculty of the University of Odontology, Montpellier, France. The
prim.ary focus of her work is biom.aterials and dental occlusion.
Appendix follows on page 134.
THE JOURNAL OF CRANIOMANDIBULAR PRACTICE 133
EFFECTS OF OCCLUSION ON POSTURE SHARIFI MILANI ET AL

Appendix
Fukuda-Unterberger Test
30 Subjects Measured, 15 =Control Group, 15 =Experimental Group

Control Group Experimental Group

Subject D D+7 D+14 D+21 Subject D D+7 D+14 D+21
1 -90.0 -90.0 45.0 90.0 1 35.0 -45.0 -20.0 5.0
2 45.0 45.0 45.0 45.0 2 -45.0 -5.0 -5.0 -5.0
3 15.0 0.0 0.0 0.0 3 55.0 55.0 45.0 5.0
4 -50.0 -50.0 -80.0 -80.0 4 45.0 60.0 60.0 60.0
5 -50.0 -50.0 -90.0 -90.0 5 -65.0 -5.0 -5.0 0.0
6 10.0 10.0 40.0 10.0 6 270.0 180.0 150.0 180.0
7 25.0 25.0 85.0 25.0 7 45.0 -30.0 -5.0 -30.0
8 -45.0 -45.0 -45.0 -45.0 8 -45.0 -45.0 -10.0 -10.0
9 90.0 90.0 90.0 90.0 9 -90.0 -45.0 -30.0 -30.0
10 -90.0 -90.0 -90.0 -90.0 10 45.0 45.0 -50.0 40.0
11 -45.0 -45.0 -90.0 -130.0 11 -45.0 -45.0 -45.0 -45.0
12 45.0 45.0 15.0 45.0 12 -25.0 -15.0 -15.0 -15.0
13 90.0 15.0 0.0 -110.0 13 -90.0 -60.0 -60.0 -75.0
14 45.0 45.0 45.0 45.0 14 25.0 -35.0 -15.0 -15.0
15 45.0 45.0 45.0 45.0 15 -75.0 -60.0 -50.0 -15.0

Progression in Comparison with Day-0

Control Group Experimental Group

Subject 7 Days 14 Days 21 Days Subject 7 Days 14 Days 21 Days
1 0.0 45.0 0.0 1 -10.0 15.0 30.0
2 0.0 0.0 0.0 2 40.0 40.0 40.0
3 15.0 15.0 15.0 3 0.0 10.0 50.0
4 0.0 -30.0 -30.0 4 -15.0 -15.0 -15.0
5 0.0 -40.0 -40.0 5 60.0 60.0 65.0
6 0.0 -30.0 0.0 6 90.0 120.0 90.0
7 0.0 -60.0 0.0 7 15.0 40.0 15.0
8 0.0 0.0 0.0 8 0.0 35.0 35.0
9 0.0 0.0 0.0 9 45.0 60.0 60.0
10 0.0 0.0 0.0 10 0.0 -5.0 5.0
11 0.0 -45.0 -85.0 11 0.0 0.0 0.0
12 0.0 30.0 0.0 12 10.0 10.0 10.0
13 75.0 90.0 -20.0 13 30.0 30.0 15.0
14 0.0 0.0 0.0 14 -10.0 10.0 10.0
15 0.0 0.0 0.0 15 15.0 25.0 60.0
Average 7.5 -2.1 -13.0 Average 22.5 36.3 39.2

134 THE JOURNAL OF CRANIOMANDIBULAR PRACTICE APRIL 2000, VOL. 18, NO. 2