The effect of occlusal alteration and masticatory imbalance on the cervical spine

The characteristics of mandibular lateral displacement include lateral inclination of the occlusal plane and the differences between the right and left masticatory muscles. The aims of this investigation were to compare the mandibular stress distribution and displacement of the cervical spine using three-dimensional finite element models (3D FEM) to simulate masticatory movements and to clarify the association between morphological and functional characteristics and head posture. A symmetrical standard model was produced (model-A). Model-B had higher masticatory muscle strength on the left side, model-C had symmetrical masticatory muscle strength but the occlusal plane was inclined upwards towards the right and model-D had the occlusal plane inclined upwards towards the right with higher masticatory muscle strength on the left side. Model-A showed a completely symmetrical stress distribution pattern, while in model-B there was an uneven distribution in the mandible with higher stress on the left side. In addition, the stress distribution in the cervical spine was asymmetrical, showing displacement to the right. Model-C showed a similar mandibular tendency to model-B but the opposite tendency in the cervical spine. In model-D, the mandibular stress distribution was markedly asymmetrical, but almost symmetrical in the cervical spine with markedly decreased lateral displacement. These results suggest that lateral inclination of the occlusal plane and imbalance between the right and left masticatory muscles antagonistically act on displacement of the cervical spine, i.e. the morphological and functional characteristics in patients with mandibular lateral displacement may play a compensatory role in posture control.