FEATURES OF THE CRANIO-MANDIBULAR COMPLEX IN ORTHODONTIC PATIENTS WITH POSTURAL BALANCE DISORDERS

Abstract

Objective. To study the clinical and functional features of the cranio-mandibular complex in orthodontic patients with postural balance disorders and to assess the relationship between occlusion type, mandibular movements, asymmetry of muscle activity, and indicators of static and dynamic posture. Methods. A prospective cohort study with parallelgroup design was conducted involving 220 patients aged 9–18 years, divided into groups depending on occlusion type: distal occlusion Class II/1 (n=80), Class II/2 (n=64), and mesial occlusion Class III (n=56). The control group included healthy children without occlusion pathology and postural disorders (n=50). The examination included assessment of mandibular movements (opening, lateral, and protrusive movements), symmetry and asymmetry of lateral movements, surface electromyography of masticatory and neck muscles, and postural balance analysis using the Zebris stabilometric platform (static and dynamic parameters, center of mass sway, head tilt, weight distribution on the feet). Statistical analysis included calculation of means and standard deviations, t-test or Mann–Whitney U-test, and correlation analysis of occlusion parameters, mandibular movements, and posture. Scientific novelty. For the first time, a comprehensive assessment of the cranio-mandibular complex in orthodontic patients with postural balance disorders was performed, allowing identification of age-related and functional features of mandibular and muscle apparatus adaptation, as well as the relationship between occlusion type and trunk and head stability disorders. The influence of morphological occlusion anomalies on lateral movement asymmetry, masticatory muscle overload, and compensatory postural regulation mechanisms was studied. Conclusions. The results showed that patients with Class II/2 and Class III had reduced amplitude of lateral and protrusive mandibular movements, greater movement asymmetry, and increased masticatory muscle activity, indicating functional disorders of the TMJ. At the same time, significant postural balance impairment was observed: increased center of mass sway, head tilt, and decreased dynamic trunk stability, especially in patients with Class III malocclusion. The data confirm the relationship between morphofunctional occlusion features and postural disorders, as well as compensatory adaptations of the musculoskeletal system, which is important for differential orthodontic planning and comprehensive assessment of the cranio-mandibular complex.