1

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for
Your Attention
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for
for
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European Academv of Sports Jision
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!POSTUROLOGIE
Sunday, April 6, 14

OCLUZIE
A.T.M

POSTURA




Congresul international
`` Postura, occlusione e salute: Milano, 7 mai 1997 ``
Sunday, April 6, 14

Introduction
Introduction
Introduction
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Sunday, April 6, 14
4
to the sphenoidal rostrum; this faint pressure allows a
slight mobilization of the sphenoid which is crucial to the
craniosacral system (Perroneaud-Ferr, 1989; Lignon,
1989; Upledger, 1996; Sutherland, 2002 a, b).
The pressure of the tongue on the retroincisor spot dur-
ing physiological deglutition also has considerable neuro-
physiological significance, as documented by recent re-
search. Particularly important is the research that has
demonstrated the presence of as many as five types of
exteroceptor in the single square centimetre of the palate
corresponding to the retroincisor spot (Halata, 1999).
Furthermore, other researchers showed that the eleva-
tion of the tongue, compared with deglutition, activates a
greater total volume of cerebral cortex, with significantly
increased activation in the cingulate gyrus, supplemen-
tary motor area, precentral and postcentral gyrus, pre-
motor cortex, putamen and thalamus (Martin, 2004).
These data give us an idea of just how important, at
neurophysiological level, the elevation movement of the
tongue is in the stimulation of the retroincisor spot, and
of the extent to which the information originating from
this zone may affect the central regulation mechanisms
of posture.
On the other hand, if it is true that deglutition is capable
of affecting posture, the opposite is also true. Correct
postural alignment is important in normal processes of
deglutition and ingestion of food: this aspect is particu-
larly striking in the field of neurological pathologies
(Redstone, 2004).
In short, we do not feel that, to date, adequate consid-
eration has been given to the fundamental nature, in
central regulation mechanisms of posture, of the infor-
mation originating from this area.
On a functional level, due to the prevalently transverse
arrangement of its fibres, the tongue may be consid-
ered a diaphragm linking the bodys anterior and poste-
rior muscular chains. Through the lingual septum and
the hyoglossus membrane, the tongue forms intimate
relationships, in the fascial plane, with the hyoid bone;
the correlation between tongue and general posture is
thus found at aponeurotic as well as at muscular level.
Still on a functional level, the whole muscular-aponeu-
rotic system that links the tongue with the internal or-
ganism, might be termed the lingual chain (Clauzade,
1989, 1992, 1998).
The lingual chain
By lingual chain we mean the ensemble of muscles and
aponeurosis topographically positioned in the antero-
medial region of the body, following a longitudinal se-
quence (Denys-Struyf, 1982; Fig. 2).
On both motor and postural levels, the lingual chain is a
functional unit; anatomically, it is made up of a very rich
network of muscles and aponeurosis, which explains its
importance in posture.
The hyo-glossus apparatus, owing to its links with the
anatomical structures at cranial, caudal, ventral, and
dorsal levels, is the true trait dunion between the oral
and postural functions of the body.
In view of its relations with the maxillaries, the skull, the
cervicals, the scapula, the pharynx and the larynx, it is
easy to appreciate the strategic influence of the hyo-
glossus apparatus on the postural system.
Normally, a lingual dysfunction causes a fulcrum of ro-
tation on the hyoid bone leading to rotation and imbal-
ance of the scapular girdle, followed by a succession of
compensations on the whole locomotor apparatus.
The tongue and the hyoid bone, thanks to the superfi-
cial cervical aponeurosis, middle cervical aponeurosis
and deep cervical aponeurosis, are able to influence
profoundly the morphopostural organization of the body
as a whole (Fig. 3).
Annali di Stomatologia 2005; LIV (1): 27-34 29
Glosso-postural syndrome
Figure 2 - Anteromedial muscular chain (Denis-Struyf, 1982).
Figure 3 - The visceral cavity in the inferior zone of the neck, as
described by Testut (1971). 1. superficial cervical fascia; 1, ster-
nocleidomastoid m.; 1 trapezius m.; 2. middle cervical fascia; 3.
deep cervical fascia; 4. prevertebral fascia; 5. common carotid
a.; 5 arterial vascular fascia; 6. sagittal segment wrapping the
sympathetic; 7. anterior scalenus wrapped in its fascia; 8. inter-
nal jugular v.; 8 venous vascular fascia; 9. sternothyroideus m.
wrapped in its fascia; 10. transverse cervical venous fascia, de-
pending on the external jugular v.; 11. vagus n. included in the
attachment of the vascular laminae; 12. lymph nodes; 13. viscer-
al cavity; 14. vasa fascia of the cephalic intestine; 15. tracheoe-
sophageal sheath where the recurrent n. resides; 16. thyroid
gland sheath or capsule; 17. retrovisceral space; 18. vertebral a.
Sunday, April 6, 14
5
HIOID
Sunday, April 6, 14
CONTROLUL POSTURII
!
VESTIBULAR
!
VIZUAL
!
PROPRIOCEPTIV
!
EXTEROCEPTIV
Sunday, April 6, 14
Postura
!
Rela!iile spa!iale ale
diferitelor segmente ale
corpului n scopul de a
men!ine echilibrul n
diferite pozi!ii statice "i
dinamice ale corpului.
!
Corela!ii culturale,
geografice, aspecte
sociale
!
Parte a comunic#rii non-
verbale
7

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Postura este o adaptare la
condi!iile mediului extern
8

BehavioraI modeI of posture
BehavioraI modeI of posture
BehavioraI modeI of posture
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10
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Controlul vizual al posturii prin
lentile de corec!ie
11

CIinicaI evidence
of the Iink between
Vision, Posture and BaIance
CIinicaI evidence
CIinicaI evidence
of the Iink between
of the Iink between
Vision, Posture and BaIance
Vision, Posture and BaIance
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12

The roIe of dentaI occIusion on
vision focusing
The roIe of dentaI occIusion on
The roIe of dentaI occIusion on
vision focusing
vision focusing
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The roIe of dentaI occIusion on
vision focusing
The roIe of dentaI occIusion on
The roIe of dentaI occIusion on
vision focusing
vision focusing
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The roIe of dentaI occIusion on
vision focusing
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The roIe of dentaI occIusion on
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vision focusing
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Cranio. 1998 Apr;16(2):109-18.
Relationship between dental occlusion and
visual focusing.
Sharifi Milani R, Deville de Periere D, Micallef JP.
Abstract
The purpose of this study is to show the effects of dental
occlusion on visual focusing. Thirty subjects were divided
into two groups: an experimental group who had worn
mandibular orthopedic repositioning appliances and a
control group who had not worn any oral device. All of the
subjects underwent the same visual focusing tests with a
Maddox rod and the Berens prismatic bars, from over five
meters to 30 centimeters. The results seemed to confirm
that the alteration of dental occlusion can induce some
fluctuations in visual focusing. The phenomenon occurs
after wearing a MORA (Mandibular Orthopedic
Repositioning Appliance) for a while. Feedback effects are
gradual after removing the mandibular splint.
Sunday, April 6, 14
Sunday, April 6, 14
14
Sunday, April 6, 14
15
Sunday, April 6, 14
EXTENSIA COLOANEI CERVICALE =
POZI!IONAREA ANTERIOAR" A
CAPULUI
!
CAUZEAZ! MODIFIC!RI ALE POZI"IEI DE
POSTUR! ORTOSTATIC! A MANDIBULEI
!
ALTER!RI ALE TRAIECTORIEI DE
NCHIDERE A GURII
!
MODIFIC!RI ALE CONTACTULUI DENTAR
INTERARCADIC INI"IAL LA NCHIDERE !
" 60%
PEDRONI et. al. Prevalence study and symptoms of temporomandibular disorders in university students,

J.Oral Rehabil, 2003;30: 283-289
Sunday, April 6, 14
17
Sunday, April 6, 14
Sunday, April 6, 14
MODIFICAREA LORDOZEI
CERVICALE
!
EXTENSIA
COLOANEI
ACTIVITATEA
MUSCULAR$ (MAS.,
TEMP.)

RIDICAREA %I
RETRUZIA
MANDIBULEI
!
FLEXIA COLOANEI
ACTIVITATEA
MUSCULAR$ (MAS.,
TEMP.)

COBORRE %I RETRUZIE
Sunday, April 6, 14
20
Proceedings of the 14
th
Triennial Congress of the International Ergonomics Association.
(2000, vol. 5, pp. 565-568).
HEAD AND NECK POSTURE AT COMPUTER
WORKSTATIONS WHATS NEUTRAL?

Dennis R. Ankrum
Human Factors Research, Nova Solutions, Inc., Effingham, Illinois USA
Kristie J. Nemeth
University of Dayton Research Institute, Dayton, Ohio USA

In a study of comfortable head/neck posture in the absence of a visual target for 24
seated subjects, mean head tilt (Ear-Eye Line) angle was 7.7 above horizontal, and mean
head/neck posture (C7-tragus against vertical) was 43.7. Using these and other studies
findings as reference points for neutral, studies examining posture at different computer
monitor heights were reviewed: eye- level monitors resulted in head/neck extension.


INTRODUCTION

Viewing a VDT involves an interaction
between two systems: vision and posture. From a
visual system standpoint, lower monitor positions
have been shown to be beneficial in terms of
accommodation, convergence and reduced risk of
Dry Eye Syndrome when compared to those at eye
level (see Ankrum, 1997 for a review). The postural
tradeoffs can be evaluated by several methods,
including that of comparing observed postures to
neutral postures. A valid estimate of neutral neck
posture is critical to any such analysis.

Neck posture recommendations in the literature

Most studies measuring neck flexion/extension
have not defined the zero starting point. For
example, Chaffin (1971) has been cited as the basis
for the recommendation not to exceed 30 of flex-
ion over sustained periods. The RULA workstation
assessment method (McAtamney and Corlett, 1993)
considers neck flexion to be of progressively greater
risk over 10 and assigns the highest risk level to
any amount of extension. However, neither article
defines the zero point from which flexion/extension
was measured. Such a reference point would be
necessary in order to apply any recommendations.

Definition of Neutral

Several attempts have been made to define
neutral of the head/neck region, but most are
reference points rather than postures of least
musculoskeletal stress. The zero point (dividing

flexion from extension) has been variously
described as: the posture of the head/neck when
standing erect and looking at a visual target at eye
level; the posture of the head/neck when standing
erect and looking at a visual target 15 below eye
level; and normal erect posture.

Physiological landmarks in measuring head/neck
posture

Head tilt.
Several landmarks have been used in defining
head tilt (see Figure 1). The simplest metric can be
called head tilt angle. Head tilt angle definitions
have utilized angles defined by the true horizontal
Figure 1. Head posture landmarks and metrics.
Jampel &Shi,
1992
Sunday, April 6, 14
Sunday, April 6, 14
22
Sunday, April 6, 14
VISSCHER et al., 2002
( LINIA POSTURII CERVICALE)
Dens axis
C7 processus
spinosus
Sunday, April 6, 14
HACK, KORITZER,
ROBINSON
(1995)
Maryland University
m.rectus
capitis
post. min.
Tuberculul
posterior al
atlasului
DURA
MATER
Text
Text
Sunday, April 6, 14
25
Sunday, April 6, 14
26
Sunday, April 6, 14
SOLOW&TALLGREN, 1971
TANGENTA LA APOFIZA ODONTOIDA
PRIN C2
TANGENTA VERTEBRELOR
CERVICALE PRIN C4
Sunday, April 6, 14
28
Sunday, April 6, 14
29
rotation for each lower limb. The subjects were also
instructed to keep their mandibles relaxed, without
having contact between the upper and lower teeth, so
that there was minimum space between the superior
and inferior tooth arcades, according to the protocol
described by Henriquez et al. (21).
To obtain lateral X-rays for the measurement of
cervical lordosis, subjects were also asked to assume a
standing position, but were instructed to maintain a
natural position of the head, so that there were no
changes of the cervical curve.
X-ray data processing
To obtain the angular measurements of cervical lordo-
sis, the Cobb method was employed (31). This method
has been widely used as the gold standard to assess
sagittal cervical spine alignment and uses, as illustrated
in Fig. 1, with the inferior border of the C
2
and C
7
vertebrae as references to obtain the angular measure
of the cervical alignment.
The positioning of the hyoid bone was obtained by
measuring the vertical and horizontal distances from
the C
3
vertebra (21). To determine the positioning of
the hyoid bone, the highest and anterior aspects were
identied, which have been frequently used as a
reference to locate the hyoid bone in cephalometric
tracings (23, 32).
The procedures were conducted in two phases to
obtain the measures of the cervical curve and location
of the hyoid bone. First, the outlines of the cervical
bone structures and the hyoid bone were traced. To
measure cervical lordosis, as shown in Fig. 1, the
following points were identied: the most anterior
and inferior, as well as posterior and inferior points of
the C
2
and C
7
vertebrae. The same procedures were
conducted for the cephalometric measures, where the
outlines of the C
3
and C
4
vertebrae and the hyoid bone
were traced, along with the most anterior and inferior
points of the C
3
vertebra (Fig. 2).
During the second phase, all tracings were digitized
and the images were transferred to locally created
software. The Cobb angle (Fig. 1) and the vertical and
horizontal distances of the hyoid bone in relation to the
C
3
vertebra (Fig. 2) were directly calculated to ensure
measurement precision.
Statistical analyses
Descriptive statistics and tests for normality were
performed, using SPSS for Windows (release 110). As
data were normally distributed, independent Students
t-tests were carried out to investigate differences
between groups for all outcome variables with a
signicance level of a < 005.
Results
Subject characteristics
The TMJ group consisted of 17 subjects (16 women
and one man), with a mean age of 2347 359
years (ranging from 20 to 35), body mass of 5727
764 kg (ranging from 44 to 77), height of 165
007 m (ranging from 152 to 187), and a body mass
index of 2092 141 kg m
)2
(ranging from 1887 to
2367). The CG was made up of 17 gender- and age-
matched participants with a mean age of 2371
339 years (ranging from 21 to 36), body mass of
5541 796 kg (ranging from 45 to 74), height of
163 008 m (ranging from 150 to 176), and a body
mass index of 2077 181 kg m
)2
(ranging from 1772
to 2389). No signicant differences were found
between groups for any demographic parameter.
Fig. 1. Measurement of cervical lordosis (reference value of 17 of
lordosis).
Fig. 2. Measurement of hyoid bone positioning (reference values
of 36 cm for the horizontal and of 04 cm for the vertical distances
between the hyoid bone and C
3
).
T MD, C E R V I C AL AL I GNME NT AND HY OI D P OS I T I ONI NG 769
2006 Blackwell Publishing Ltd, Journal of Oral Rehabilitation 34; 767772
rotation for each lower limb. The subjects were also
instructed to keep their mandibles relaxed, without
having contact between the upper and lower teeth, so
that there was minimum space between the superior
and inferior tooth arcades, according to the protocol
described by Henriquez et al. (21).
To obtain lateral X-rays for the measurement of
cervical lordosis, subjects were also asked to assume a
standing position, but were instructed to maintain a
natural position of the head, so that there were no
changes of the cervical curve.
X-ray data processing
To obtain the angular measurements of cervical lordo-
sis, the Cobb method was employed (31). This method
has been widely used as the gold standard to assess
sagittal cervical spine alignment and uses, as illustrated
in Fig. 1, with the inferior border of the C
2
and C
7
vertebrae as references to obtain the angular measure
of the cervical alignment.
The positioning of the hyoid bone was obtained by
measuring the vertical and horizontal distances from
the C
3
vertebra (21). To determine the positioning of
the hyoid bone, the highest and anterior aspects were
identied, which have been frequently used as a
reference to locate the hyoid bone in cephalometric
tracings (23, 32).
The procedures were conducted in two phases to
obtain the measures of the cervical curve and location
of the hyoid bone. First, the outlines of the cervical
bone structures and the hyoid bone were traced. To
measure cervical lordosis, as shown in Fig. 1, the
following points were identied: the most anterior
and inferior, as well as posterior and inferior points of
the C
2
and C
7
vertebrae. The same procedures were
conducted for the cephalometric measures, where the
outlines of the C
3
and C
4
vertebrae and the hyoid bone
were traced, along with the most anterior and inferior
points of the C
3
vertebra (Fig. 2).
During the second phase, all tracings were digitized
and the images were transferred to locally created
software. The Cobb angle (Fig. 1) and the vertical and
horizontal distances of the hyoid bone in relation to the
C
3
vertebra (Fig. 2) were directly calculated to ensure
measurement precision.
Statistical analyses
Descriptive statistics and tests for normality were
performed, using SPSS for Windows (release 110). As
data were normally distributed, independent Students
t-tests were carried out to investigate differences
between groups for all outcome variables with a
signicance level of a < 005.
Results
Subject characteristics
The TMJ group consisted of 17 subjects (16 women
and one man), with a mean age of 2347 359
years (ranging from 20 to 35), body mass of 5727
764 kg (ranging from 44 to 77), height of 165
007 m (ranging from 152 to 187), and a body mass
index of 2092 141 kg m
)2
(ranging from 1887 to
2367). The CG was made up of 17 gender- and age-
matched participants with a mean age of 2371
339 years (ranging from 21 to 36), body mass of
5541 796 kg (ranging from 45 to 74), height of
163 008 m (ranging from 150 to 176), and a body
mass index of 2077 181 kg m
)2
(ranging from 1772
to 2389). No signicant differences were found
between groups for any demographic parameter.
Fig. 1. Measurement of cervical lordosis (reference value of 17 of
lordosis).
Fig. 2. Measurement of hyoid bone positioning (reference values
of 36 cm for the horizontal and of 04 cm for the vertical distances
between the hyoid bone and C
3
).
T MD, C E R V I C AL AL I GNME NT AND HY OI D P OS I T I ONI NG 769
2006 Blackwell Publishing Ltd, Journal of Oral Rehabilitation 34; 767772
Text
M#surarea lordozei cervicale $i a pozi%iei osului hioid (Andrade et al.,
2007- Journalof Oral Rehabilitation; 34:767-772
Sunday, April 6, 14
30
Sunday, April 6, 14
31
Sunday, April 6, 14
32
Sunday, April 6, 14
33
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34
Sunday, April 6, 14
35
Sunday, April 6, 14
36
Sunday, April 6, 14
37
Sunday, April 6, 14
TORTICOLLIS OFTALMOLOGIC
TORTICOLLIS INTRINSEC
CAUZELE DEFICITELOR
POSTURALE :
Intrinseci
Dobandite
Oculare
Globale
Sunday, April 6, 14
Implica!ii directe n protetica
dentar" :

transferul n articulator al pozi!iei

modelului superior;

determinarea planului de ocluzie

alterarea pozi!iei condililor mandibulari n

plan frontal
39
Sunday, April 6, 14
Sunday, April 6, 14
41
Sunday, April 6, 14
42
Sunday, April 6, 14
Sunday, April 6, 14
Sunday, April 6, 14
45
Sunday, April 6, 14
46
Sunday, April 6, 14
Sunday, April 6, 14
Aqualiser
Sunday, April 6, 14
49
Sunday, April 6, 14
50
Sunday, April 6, 14
Sunday, April 6, 14
Sunday, April 6, 14
Sunday, April 6, 14
EXAMENUL CLINIC
POSTURAL

MORFOLOGIC

DINAMIC

FUNCTIONAL
#
ROMBERG
#
CYONAS, FUKUDA
#
REFLEXE POSTURALE
LABIRINTICE
#
POSTUROMETRIA
#
EMG; EEG
#
EXAMINARE OFTALMOLOGICA
Sunday, April 6, 14
LINIA GRAVITATIEI ( BARRE) :
Din norm! lateral!:
Linia gravita"ional! trece prin:
a. Vertex.
b. Inaintea mastoidei.
c. Anterior de axa de flexie !i
extensie a gtului
d.Intersecteaz" acromionul
e. Corpul vertebrelor C1,C6,T11,
L5, S1 ( trece posterior de
axele de rota#ie a vertebrelor
cervicale !i lombare !i
anterior de cele toracale)
f. Prin sau naintea axului
articula#iei !oldului
g. Anterior de axa articula#iei
genunchiului
h. 5 cm anterior de maleol"
Sunday, April 6, 14
70 60 45
Sunday, April 6, 14
40
Sunday, April 6, 14
58
ROMBERG
Sunday, April 6, 14
59
REACTIA POSTURAL" OCULOMOTORIE
Sunday, April 6, 14
60
TESTUL POSTURAL CERVICAL CYON-PAILLARD (pentru membrele
superioare)
Sunday, April 6, 14
61
TESTUL POSTUROLOGIC CERVICAL FUKUDA
Sunday, April 6, 14
62
TESTUL POSTURAL LABIRINTIC
Sunday, April 6, 14
63
Sunday, April 6, 14
64
Sunday, April 6, 14
65

Thank You
for
Your Attention
Thank You
Thank You
for
for
Your Attention
Your Attention
!"#$ &"'
$()"&$* +
European Academv of Sports Jision
www.easv.org
Sunday, April 6, 14