10.59987/ads/2012.3-4.113-118
The purpose of this study was to evaluate the influence of an orthopedic oral device on the performance of competitive athletes. Seven athletes from different sports have been examined during athletic tests with and without an oral device. The athletes were examined by two calibrated gnathologic operators and with specific radiography. All of the subjects were submitted to a postural exam on an electronic platform with and without the oral device applied. All subjects underwent objective tests, performed by federal trainers in specialized centers, to evaluate the athletic performance with and without the occlusal splint. The results showed an improvement of all the tests carried out. Our findings lead us to believe that the use of a costumed oral device, it is able to optimize neuro-muscular coordination and to improve the competitive performance of athletes, while the muscular strength not respond significantly.
application/pdf
1971-1441
152
3-4
en
C. Di Paolo
https://creativecommons.org/licenses/by-nc-nd/4.0
Annali di stomatologia
athletes performances
Influence of occlusal splint on competitive athletes performances
Text.Serial.Journal
https://www.annalidistomatologia.eu/ads
3
Original Article
2022-08-17
2022-08-17
2012-12-01
2023-12-04
113-118
Ann Stomatol (Roma)
C. Di Paolo
2012
10.59987/ads/2012.3-4.113-118
113
1971-1441
3-4
athletes performances
en
118
Influence of occlusal splint on competitive athletes performances
https://www.annalidistomatologia.eu/ads/article/download/152/135
3
                                                                                                      Original article


Influence of occlusal splint on competitive
athletes performances




                                                                                             li
                                                                                          na
Vittorio D’Ermes, MD, PhD3                                   cal-thoracic-lumbar spine with occasional associations
Mario Basile, MD2                                            to the sacred girdle, the pelvic girdle, hip joints, knees and




                                                                                       io
Alessandro Rampello, MD2                                     toes. The maintenance of good postural balance be-
Carlo Di Paolo, MD1                                          tween all these segments allows the human body to
                                                             maintain a feasible and ergonomic energy efficiency. This
                                                             postural balance facilitates the dynamic functions (7),




                                                                                    az
1
    Associate Professor Head Responsible of Unit             which is particularly important in the presence of struc-
    of Clinical Gnathology - Department of Oral and          tured subjects and qualitatively active persons such as
    Maxillofacial Sciences, Sapienza University of Rome      high level competitive athletes.
2
    Private Professional Dentists in Rome                    Several studies have been proposed with the aim to high-




                                                                     n
3
    Department of Oral and Maxillofacial Sciences            light correlations between the dento-mandibular apparatus
    Sapienza University of Rome                              and the skeletal muscle system of the human body even




                                                                  er
                                                             in regions distant from the oral cavity (4,6,29,32,33).
                                                             The first scientific studies were based on dental kinesiol-
Corresponding author:                                        ogy, which was first developed in America in the mid-nine-
Vittorio D’Ermes, MD, PhD
Department of Oral and Maxillofacial Sciences
Sapienza University of Rome
Via Caserta 6
                                               nt            teenth century by Daniel David Palmer (1895). Today, fur-
                                                             ther insights have led to the development of applied
                                                             kinesiology, which earnings precise attention to the tem-
                                                             poromandibular joint (TMJ) (8-10).
                                             iI
00162 Roma, Italy                                            In a work presented by Gelb in 1977 he noted an improve-
Phone: +39 3282570935                                        ment in the performance of competitive athletes after the
E-mail: vittoriodermes@libero.it                             application of a special orthopedic interocclusal device
                                           on

                                                             which he called MORA (Mandibular Orthopedic Reposi-
                                                             tioning Appliance) (11-13).
Summary                                                      Iwasaki in 1994 (14) investigated the forces of occlu-
The purpose of this study was to evaluate the influence      sion in athletes. He concluded that the maximum force
                                 i


of an orthopedic oral device on the performance of           in occlusion was significantly higher than those of nor-
                              iz


competitive athletes. Seven athletes from different          mal individuals, showing a relation between the mas-
sports have been examined during athletic tests with         ticatory muscles involved in dental occlusion mecha-
and without an oral device. The athletes were examined       nism and the force developed by the spine postural
              Ed




by two calibrated gnathologic operators and with spe-        muscles.
cific radiography. All of the subjects were submitted to
                                                             An analysis of current scientific literature reveals that
a postural exam on an electronic platform with and
                                                             there is still a limited amount of works on this topic with a
without the oral device applied. All subjects under-
                                                             little scientific reliability (16), because there are no ran-
went objective tests, performed by federal trainers in
                                                             domized trials and/or meta-analysis that may help to clar-
specialized centers, to evaluate the athletic perform-
                                                             ify the relationship between occlusion, TMJ, and sports
 IC




ance with and without the occlusal splint. The results
showed an improvement of all the tests carried out.          performance (36).
Our findings lead us to believe that the use of a cos-       Some recent studies assess muscular and postural
tumed oral device, it is able to optimize neuro-muscu-       changes through kinesiology tests (26), but they are not
                                                             complete nor do they provide the proven scientific valid-
C




lar coordination and to improve the competitive per-
formance of athletes, while the muscular strength not        ity of such tests as the Meesserman test or the stomatog-
respond significantly.                                       nathic reset (17,18,34).
                                                             On the other and, the relationship between occlusion, the
Key words: splint, postural balance, athletes perform-       mandible, posture and musculature has gained much
©




ances.                                                       more importance in sports (15,19,21,22,31). Since com-
                                                             petitive at athletes require a high performance level to
                                                             achieve maximum results, they exercise at the highest
Introduction                                                 levels of their physical limits, and they stress the physical
                                                             structure more exhaustively and rapidly allowing a more
Clinical experience and scientific research has found that   comprehensive analysis of the possible reciprocal influ-
there are frequent symptomatic connections between the       ences of the correlations (30). Applying scientific methods
elements that form the postural chain (1-3), particularly    to study athletes would therefore be desirable to obtain
between the cranial-mandibular structures and the cervi-     more concrete evidence of the relationship between oc-

Annali di Stomatologia 2012; III (3/4): 113-118                                                                       113
V. D’Ermes et al.


clusion, mandible, posture and skeletal muscle system                  ified by the Unit of Gnathology of the Department of
(27-28). At the same time, however, the recruitment of                 Oral and Maxillofacial Sciences of University of Rome
these subjects, and their continued commitment, does not               which are based on integrating the international
allow constant monitoring or easy availability (20,35).                Rdc/Tmd. The exclusion criteria included: having under-
The purpose of this article is to analyze any changes                  gone previous ortognatodontic treatments; presence




                                                                                                      li
in the athletic performance of national and interna-                   of prosthetic restorations; cervical, dorsal, lumbar or
tional competitors, before and after the application of                temporomandibular pain; worst in general health; tak-




                                                                                                   na
an intraoral device, such as a occlusal appliance or                   ing medication; no more than two missing teeth for emi
splint. Athletes of different sport disciplines were se-               jaw, including third molars. The occlusal class was not
lected and diagnostic tools associated with scientifically             considered as a valid selection criterion. All these cri-
verifiable postural tests to measure the performance                   teria were evaluated clinically by 2 specialists previously




                                                                                                io
were used.                                                             calibrated.
                                                                       Therefore, according to the subjective willingness of the
                                                                       athletes to join the study and the characteristics required
Materials and methods                                                  by the selection criteria, the study was conducted on a to-




                                                                                             az
                                                                       tal of seven athletes: two swimmers, a boxer, four rugby
The sample selection involved the search for competitive               players (Tab. 1).
athletes who had an high level activity inserted into a na-            They were all of national and international competitive
tionally and internationally recognized federation, there-             level, with many victories under their belts and well aware




                                                                               n
fore those who had already followed standardized exer-                 of their potential maximum, accredited to federations and
cise protocols.                                                        followed by federal coaches. The athletes were six male




                                                                            er
The athletes were selected according to the authors’ abil-             and a female with mean age of 25 years. They were
ity to contact the offices of sports training facilities and the       contacted by their respective sport’s federation, their in-
positive response to the project by the company. The                   dividual coaches, and through individual contacts for the


                                             nt
sports selected were: swimming, boxing, rugby.
The second stage of selection was directly related to the
availability of competitive athletes. Among the subjects
chosen were those with residence in Rome and sur-
                                                                       direct management and recording of clinical and instru-
                                                                       mental data.
                                                                       Each athlete was subjected to the following collection of
                                                                       records:
                                           iI
rounding for practical and logistical reasons. The initial             - extraoral and Intraoral photographs;
sample was 21 athletes.                                                - orthopanoramic and individualized tomographic study
From this initial screening all subjects underwent a                        of TMJ.
                                         on

specialist visit to assess the exclusion criteria, which               To test the hypothesis of the study, we recorded changes
was applied to reduce the influence of occlusion and to                in competitive results as a result of changes in the oc-
determine the health of the TMJ and masticatory mus-                   clusal proprioceptions, with a removable interocclusal
cles. This was done following the diagnostic criteria cod-             device applied to all subjects.
                                i
                             iz



                                Sport                          Sex                     Age                      N. dental
              Ed




                                                                                                            elements missing


Athlete 1                     Swimming                             F                    26                            4
 IC




Athlete 2                     Swimming                             M                    24                            0


Athlete 3                       Boxing                             M                    27                            5
C




Athlete 4                       Rugby                              M                    23                            4
©




Athlete 5                       Rugby                              M                    23                            0


Athlete 6                       Rugby                              M                    24                            0


Athlete 7                       Rugby                              M                    32                            0

Table 1.


114                                                                                    Annali di Stomatologia 2012; III (3/4): 113-118
Influence of occlusal splint on competitive athletes performances


The appliance used in the study needed to be a device            For the two swimmers (swimmer 1: dolphin style; swim-
which had to facilitate easy insertion and extraction. It had    mer 2: freestyle) the average time for each session were
to place minimal stress on the teeth, and to be as small         calculated. Each athlete was subjected to:
as possible in the mouth. It also had to have good dimen-        - stabilometric platform with and without bite;
sional stability, well-polished contact surfaces with bound-     - detection performance with professional timing made




                                                                                                li
aries that would comply with the gums and mucous mem-                by federal coaches.
branes. It had to have rounded edges to prevent                  For the boxer and four rugby players instead, where we




                                                                                             na
disturbance to the tongue, and it had to allow for easy          could not have seen the results on the track type of train-
swallowing and breathing. Finally, it could not be fitted with   ing, they were submitted to:
metal anchors, but constructed to be stabilized by using         - stabilometric platform with and without bite;
natural undercuts. The material used had to be biocom-           - mognoni Test;




                                                                                          io
patible, non-toxic, non-allergenic, odorless, and taste-         - lactate PRO ARKRAY test.
less. We therefore chose an elastomer, SBS (styrene-bu-          The performance evaluation for the boxer and rugby
tadiene-styrene). In addition to the above mentioned             players was performed using the Mognoni test for the cal-
requirements we also added the following clinical re-            culation of instantaneous spot heart rate and ending




                                                                                       az
quirements: a defined occlusal stability, a valid condyle-       heart rate, and the Lactate PRO ARKRAY test for the
disc-fossa relationship and a repeatable and efficient           measurement of lactic acid produced during the exercise.
neuromotor pattern.                                              In the Mognoni test every athletes had to perform 1350
The choice fell on oral devices with functional orthope-         meters in 6 minutes while maintaining a constant speed




                                                                         n
dic repositioning that allowed for a joint occlusal-de-          of 13.5 Km / h. To make the test accurate and reliable,
fined position and to be guided and easily modified by           pins were positioned on the path at regular intervals




                                                                      er
the control data performed by instrumental examina-              (every 50 m) so that athletes could get an audio signal
tions. Furthermore, the splint was considered as the             when they passed over a pin. The Lactate PRO ARKRAY
occlusal device best suitable for the study in question          test allowed us to measure with extreme easy and pre-


                                               nt
since it is bound to the jaw and is best able to express
the physical exertion of the subject. It was applied to
the upper arch during competitive activities of the ath-
letes to evaluate the influence of occlusion on the
                                                                 cision the blood lactate level and a precise volume of
                                                                 blood (5 microliters).
                                             iI
physical activity and its effect on skeletal muscle per-         Results
formance.
The dental plate was constructed with the indirect method        The results showed how one of the most important pa-
                                           on

of using the die casting technique. The impressions were         rameters of the evaluation carried out on the postural
first taken with alginate and from these plaster casts           stabilometric platform, i.e. the percentage of load di-
were derived. Individual custom trays were then designed         vided into the two supports breech, is modified with and
for a second cast of precision silicone. The models were         without the occlusal splint insertion. In fact, the varia-
                                 i


then placed in the articulator and the centric relation was      tion of the percentage of load varies from a maximum
                              iz


detected by recording the wax occlusal position of the           of 6% (rugby player 4) to a minimum of 1% (boxer),
mandible. The flasking model was then made and ran the           with a single case of neutrality (rugby player 2). There-
injection cycle:                                                 fore an average variation of 3% in static load between
              Ed




• melting temperature: 165 oC;                                   the values with and without the oral plate were ob-
• holding time above the melting point: 20 minutes;              tained.
• cooling time under pressure: 20 minutes;                       The performance time of the two swimmers were as fol-
• injection pressure: 4 bar.                                     lows:
After building the plates, they were tested for each ath-
lete in order to customize the features and to clinically        Swimmer 1:
 IC




evaluate, through instrumental examination, the effec-           - 100 meter dolphin style: the average time without
tive global postural balance prior to their use during the          the bite was between 1 minute and 28 seconds and
active competitive phase. The stabilometric platform                1 minute and 32 seconds, while with the bite a con-
was performed with the purpose of evaluating the pos-               stant average of 1 minute and 25 seconds were ob-
C




tural balance of the subject and the eventual changes               tained.
when the oral device was used. And then it was re-
peated after the agonistic performance to check for              Swimmer 2:
any changes.                                                     - 100 meters freestyle: the average time without the bite
©




All measurements were performed 10 times each in total,             was 1 minute and 16 seconds, with the bite the aver-
with and without the oral splint, at 30 day intervals.              age was 1 minute and 14 seconds.
The training sessions were organized in consecutive                 The boxer and the four rugby players reported the fol-
days as follows:                                                    lowing heart rate values expressed in bpm and rela-
- the first day workout without bite;                               tive values of lactic acid produced expressed in mil-
- second day: training with bite;                                   limoles (ml/mol) checked one minute after the end of
Each athlete carried out the exercise in their own specific         the Mognoni test with (Tab. 2) and without the splint
discipline.                                                         (Tab. 3).


Annali di Stomatologia 2012; III (3/4): 113-118                                                                         115
V. D’Ermes et al.



                      Heart rate       Bpm 1’ after end of test        Lactic Acid in ml/mol

Boxer               After 1’ 146 bpm             140                              2,7
                       3’ 151 bpm




                                                                           li
                       5’ 158 bpm
                       6’ 164 bpm




                                                                        na
Rugby player 1      After 1’ 167 bpm             165                             11,6
                       3’ 180 bpm
                       5’ 186 bpm




                                                                     io
                       6’ 189 bpm

Rugby player 2      After 1’ 160 bpm             151                              5,3




                                                                  az
                       3’ 173 bpm
                       5’ 178 bpm
                       6’ 182 bpm




                                                    n
Rugby player 3      After 1’ 160 bpm             169                              8,7
                       3’ 168 bpm




                                                 er
                       5’ 171 bpm
                       6’ 181 bpm

Rugby player 4      After 1’ 163 bpm             174                             10,1


                            nt
                       3’ 171 bpm
                       5’ 178 bpm
                       6’ 179 bpm
                          iI
Table 2.
                        on

                      Heart rate       Bpm 1’ after end of test        Lactic Acid in ml/mol
                       i


Boxer               After 1’ 144 bpm             119                              2,4
                    iz


                       3’ 150 bpm
                       5’ 156 bpm
                       6’ 156 bpm
            Ed




Rugby player 1      After 1’ 158 bpm             148                             10,8
                       3’ 173 bpm
                       5’ 174 bpm
                       6’ 178 bpm
 IC




Rugby player 2      After 1’ 159 bpm             137                              8,1
                       3’ 168 bpm
                       5’ 174 bpm
C




                       6’ 176 bpm

Rugby player 3      After 1’ 150 bpm             154                              6,7
                       3’ 167 bpm
©




                       5’ 169 bpm
                       6’ 173 bpm

Rugby player 4      After 1’ 155 bpm             105                              8,4
                       3’ 163 bpm
                       5’ 165 bpm
                       6’ 168 bpm

Table 3.


116                                                        Annali di Stomatologia 2012; III (3/4): 113-118
Influence of occlusal splint on competitive athletes performances


Discussion                                                      The cronometric values, the results obtained from com-
                                                                puter platforms, the heart rate values and the Lactate
The purpose of this study was to assess any changes that        PRO ARUPAY test, all significantly changed in a positive
could occur with the application of an occlusal splint in the   way with the application of a bite. It would seem that the
athletic performance of national and international compet-      mechanical receptive stimulus created by changing the ra-




                                                                                               li
itive athletes.                                                 tio of occlusal-mandibular posture is able to influence the
The sample of competitive athletes had been selected so         work of the muscles and of the neuromuscular component.




                                                                                            na
as to be free of dysfunctional problems, and that would         The results of our study are consistent with those pre-
meet the above requirements. All athletes were subjected        sented by Edwards (22,23), which showed that the oc-
to the stabilometric platform to evaluate postural muscle,      clusal relationships can interfere with both the body pos-
and from this we saw a change in the distribution of the        ture and neuromuscular balance.




                                                                                         io
load resting on both feet, and therefore posture.               The most important limits of our study are in the number
                                                                of samples examined and the diversity of sports investi-
                                                                gated. Then, the data obtained is numerically small and
                                                                the comparison of that does not allow for more than a de-




                                                                                      az
                                                                scriptive analysis of the base and not a statistical obser-
                                                                vation. Considering these limits, the results still seem to
                                                                indicate that the presence of an occlusal splint can lead
                                                                to greater control of neuromotor coordination, resulting in




                                                                        n
                                                                improved efficiency and effectiveness of competitive
                                                                sports performance.




                                                                     er
                                                                A study conducted on high-level professional athletes
                                                                can analyze the change of body patterns and the neuro-
                                                                muscular dynamics but not the change in dysfunctional



                             Fig. 1            nt               symptoms (24,25). These subjects express dynamic
                                                                movement of the entire body at the highest levels of
                                                                stress to neuro-musculo-articular relationships and may
                                                                therefore represent the best individuals to be studied to
                                             iI
                                                                evaluate these relationships.
With the bite inserted, the percentage values of the load
distribution were more likely to approach the ideal bal-
                                           on

ance, i.e. 50% of load resting on the right foot and 50%        Conclusions
of resting on the left foot.
Figure 1 shows the mean values of the load distribution         The study showed, in the subjects examined, a positive
on both sides, right and left, and displays how with the bite   influence that a stimulus balancing occlusal device seems
                                 i


inserted these values tend to be closer to an equitable         to have on the sporting performance of national and inter-
                              iz


sharing of the percentages. In fact, starting from an aver-     national competitive athletes. Restoring a better balance
age load distribution of 48.3% on the left and right of         in the occlusal receptor could allow an improvement of the
51.7% without support of the bite we get to a distribution      neuro-muscular dynamic and to learn more effective mo-
              Ed




load value of 50.4% on the left and 49.6% on the right with     tor patterns. These observations are sequential changes
the bite inserted.                                              in a positive sense of the competitive performance of
The variation from an ideal condition (50% of load support      athletes who were involved in this preliminary analysis.
for both sides) without the repositioning bite is 1.7%,         In all of the athletes of this study, the application of a
while with mandibular bite in place it is 0.4%.                 mandibular bite resulted in a better balanced redistribu-
The swimmers found a decrease in time at 100 meters for         tion of the load between the two sides of the body, demon-
 IC




their own style. Swimmer 1 without the bite took 1 minute       strating the role that the dental occlusion has in posture
and 29 seconds on average; while with the bite in place,        through the neuromuscular system, and that these are
Swimmer 1’s time improved by about 4 seconds on aver-           such as to influence the muscular work itself.
age, down to 1 minute and 25 seconds constants. The             In the fact, with the bite, the two swimmers improved the
C




same goes for the Swimmer 2, which had improved time            water resilience, achieved a greater resistance to fatigue,
of approximately 2 seconds passing from 1 minute and 16         and enhanced the performance during the training ses-
seconds to 1 minute and 14 seconds.                             sions. In addition they have obtained excellent competi-
The boxer and the four rugby players, in addition to the        tive performance that saw Swimmer 1 qualify for the first
©




improvement of the values recorded with stabilometric           time in tenth place in the World Championship 2006 Mas-
platform, recorded a decrease in the production of lactic       ters Champion and she became Italian Champion in the
acid when they practiced the exercise test with a bite and      50 meters dolphin style.
how the intra-oral device had also impacted the heart rate      Worthy of note also are the results of the boxer who won
values.                                                         the title of the European Union Welterweight. Finally, for
This means that, with bite, there is a decrease in muscu-       the latter as for the four rugby players, instrumental val-
lar effort. This made be due to the drop of the production      ues, confirmed by heart rates and those of lactate pro-
of lactic acid and heart rate leadind to a better recovery      duced, showed that the changes of the neuro-musculo-
time after muscular effort.                                     joint mediated by mandibular repositioning bite have a

Annali di Stomatologia 2012; III (3/4): 113-118                                                                        117
V. D’Ermes et al.


positive impact on the work of the body’s muscles, lead-                19. Veltri N, Basile F, Giammatei S. Posture errate: kinesiologia
ing to better muscle performance and to less fatigue.                       applicata. Diagnosi e terapia in campo odontoiatrico (Doc-
The final results are therefore auspicious. The setting of                  tor OS; 1992; 8).
scientific and clinical studies are desireable when validated           20. Aloi A. Cranio Clin Int. 1991;1(2):99-105.
                                                                        21. Lai V, Deriu F, Chessa G. The influence of occlusion on
and found to allow for standardization of protocols. As with
                                                                            sporting performance. Minerva Stomatol. 2004 Jan-Feb;53(1-




                                                                                                          li
Formula 1 racing where technological developments are                       2):41-7.
later adopted by the broader market, the opportunity to                 22. Esposito GM. Teoria del range propriocettivo tridimensionale




                                                                                                       na
benefit from the availability of athletes at this level should              Occlusale. Il Dentista Moderno, maggio 1989.
be managed so that the results which emerge from the re-                23. Esposito GM. Il triangolo della salute. Salutenatura, Anno 1,
search could lead to developments that can lead to pos-                     n°0, febbraio 1989.
sible positive effects on the daily life of each individual.            24. Roettger M. Compend Contin Educ Dent. 2009 Jul-Aug; 30
                                                                            Spec No 2:4-8.




                                                                                                    io
                                                                        25. Verban EM Jr. The MORA. Its application in the field of ath-
                                                                            letics. Basal Facts. 1987;9(2):63-8.
References                                                              26. Nozaki S, Kawai M, Shimoyama R, Futamura N, Matsumura




                                                                                                 az
                                                                            T, Adachi K, Kikuchi Y. Range of motion exercise of temporo-
1.    Strini, Machado, Gorreri, Ferreira, Sousa, Fernandes Nedo:            mandibular joint with hot pack increases occlusal force in pa-
      J Appl Oral Sci. 2009; 17(5):539-43.                                  tients with Duchenne muscular dystrophy. Acta Myologica •
2.    Wright, Domenech Fischer jr: JADA, Vol.131 February 2000;             2010; XXIX: p. 392-39.
      202-210.                                                          27. Manfredini D, Castroflorio T, Perinetti G, Guarda-Nardini L.




                                                                                 n
3.    Esposito GM. Valutazione della relazione esistente tra l’oc-          Dental occlusion, body posture and temporomandibular dis-
      clusione e la postura. Il dentista moderno Maggio 1989.               orders: where we are now and where we are heading for. J




                                                                              er
4.    Esposito GM. Problemi posturali di pertinenza odontostoma-            Oral Rehabil 2012 Jun;39(6):463-71.
      tologica. Il dentista moderno. Maggio 1988.                       28. Moon HJ, Lee YK.The relationship between dental occlu-
5.    Schubert MM, Guttu RL, Hunter LH, Hall R, Thomas R.                   sion/temporomandibular joint status and general body health:
      Changes in shoulder and leg strength in athletes wearing              part 1. Dental occlusion and TMJ status exert an influence


6.                                               nt
      mandibular orthopedic repositioning appliances. J Am Dent
      Assoc. 1984 Mar;108(3):334-7.
      Sannajust, Thiery, Poumarat, Vanneuville, Barthélémy,
      Mondie. Rev.Stomatol Chir Maxillofac. 2002 Jun;103(3):
                                                                            on general body health. J Altern Complement Med 2011
                                                                            Nov;17(11):995-1000.
                                                                        29. Michelotti A, Buonocore G, Manzo P, Pellegrino G, Farella M.
                                                                            Dental occlusion and posture: an overview. Epub 2011 Jan
                                               iI
      141-7.                                                                20 Prog Orthod 2011;12(1):53-8.
7.    Urzi D. Protocollo interdisciplinare di valutazione dei sistemi   30. Baldini A, Beraldi A, Nota A, Danelon F, Ballanti F, Longoni
      di controllo posturale. Formenti 1997.                                S. Gnathological postural treatment in a professional basket-
                                             on

8.    Gerz A. Kinesiologia applicata, storia e fondamenti. Medicina         ball player: a case report and an overview of the role of den-
      Naturale, Aprile 1993.                                                tal occlusion on performance. Annali di Stomatologia 2012,
9.    Esposito GM. 2° Congresso mondiale di kinesiologia. Garda             3(2):51-58.
      5 Ottobre 1995.                                                   31. Manfredi M, Lombardo L, Bragazzi R, Gracco A. An investi-
10.   Scalia. Osteopatia e Kinesiologia applicata. Marrapese Edi-           gation into explosive force variation using occlusal bites.
                                    i


      tore, 1999, Roma.                                                     Prog Orthod 2009;10(2):54-63.
                                 iz


11.   David S. Walther: Una nuova teoria in Kinesiologia odontoia-      32. Tardieu C, Dumitrescu M, Giraudeau A, Blanc JL, Cheynet
      trica. Kinesiologia applicata - synopsis - 1998 - Systems             F, Borel L. Dental occlusion and postural control in adults.
      DC.                                                                   Neuroscience Letters 2009, 450(2):221-224.
                Ed




12.   Gelb H, Mehta NR, Forgione AG. N Y State Dent J. 1995             33. Bergamini M, Pierleoni F, Gizdulich A, Bergamini C. Dental
      Nov; 61(9):58-66.                                                     occlusion and body posture: a surface EMG study. Cranio
13.   Allen ME, Walter P, McKay C, Elmajian A. Can J Appl Sport             2008 Jan;26(1):25-32.
      Sci. 1984 sep; 9(3):148-52.                                       34. Cuccia AM. Interrelationships between dental occlusion and
14.   Iwasaki H, Inaba R, Iwata H. Nippon Eiseigaku Zasshi 1994             plantar arch. Journal of Bodywork and Movement Therapies
      Aug; 49(3):654-9.                                                     2011, 15(2):242-250.
 IC




15.   Gangloff, Louis, Perrin. Neuroscience Letters 293(2000)           35. Sakaguchi K, Mehta NR, Abdallah EF, Forgione AG, Hi-
      203-206.                                                              rayama H, Kawasaki T, Yokoyama A. Examination of the re-
16.   Gelb, Mentha, Forgione. Cranio 1996 oct; 14(4):320-5.                 lationship between mandibular position and body posture.
17.   CONSENSUS CONFERENCE 2008 Milano.                                     Cranio 2007 Oct;25(4):237-49.
18.   Esposito GM. Problemi posturali di pertinenza odontostoma-        36. Hanke BA, Motschall E, Türp JC. Association between ortho-
C




      tologica (Atti del II° Congresso Mondiale di Kinesiologia,            pedic and dental findings: what level of evidence is available?
      Garda, 1995).                                                         J Orofac Orthop 2007 Mar;68(2):91-107.
©




118                                                                                        Annali di Stomatologia 2012; III (3/4): 113-118
