Dental Occlusion and Ophthalmology: A Literature Review

Abstract

Stomatognathic system is strictly correlated to other anatomical regions; many studies investigated relationship between temporomandibular joint and posture, several articles describe cranio-facial pain from dental causes, such as trigger points. Until now less interest has been given to connections between dental occlusion and ophthalmology, even if they are important and involving. Clinical experience in dental practice claims that mandibular latero-deviation is connected both to eye dominance and to defects of ocular convergence. The trigeminal nerve is the largest and most complex of the twelve cranial nerves. The trigeminal system represents the connection between somitic structures and those derived from the branchial arches, collecting the proprioception from both somitic structures and oculomotor muscles. The intermedius nucleus of the medulla is a small perihypoglossal brainstem nucleus, which acts to integrate information from the head and neck and relays it on to the nucleus of the solitary tract where autonomic responses are generated. This intriguing neurophysiological web led our research group to investigate anatomical and functional associations between dental occlusion and vision. In conclusion, nervous system and functional pathways strictly connect vision and dental occlusion, and in the future both dentists and oculists should be more and more aware of this correlation for a better diagnosis and therapy.

A Device Improves Signs and Symptoms of TMD

“…In sleep apnea patients, the mandibular position is abnormal, in part because during sleep, the tongue is more retruded than in healthy people [41, 42]. Functionally, the mandible, neck/head, and tongue are strictly associated in some reflex activities which induce a perpetual arrangement of reciprocal muscular tone [43, 44]. Stimulation of the lingual nerve, sensorial secondary branch of mandibular division of the trigeminal nerve (CN Vdiv3), determines the discharge of hypoglossal nerve fibers which concurrently cause tongue retrusion [45].…”

“…In the intermediate nucleus of the medulla, the proprioception of suboccipital muscles, sternocleidomastoid, and trapezius is monosynaptical and related with the nucleus of the twelfth cranial nerves and with the nucleus of the solitary tract, this justifying the functional union among neck, head, and tongue and the vegetative answers inducted by postural variations of every element of this circuit. Among them are also some afferent fibers to the intermediate nucleus coming from vestibular and oculomotor nucleus [44]. It is also interesting to note that the tongue posture, position of apex of the tongue, and freeway space are correlated to watchfulness and mood.…”

Management of OSAS: The ELIBA® Device Can Help the Patient?

“…The Medium Longitudinal File, which allows a direct connection between the various cranial nerves, can provide a way to link the upper spinal cord to the mesencephalus. The ELIBA® works by way of proprioception and interception, in which it stimulates the trigeminal system and, consequently, activates the oculomotor system to help maintain appropriate tongue position and movement [28]. Contact of the tongue apex with its designated spot during the night together with perioral muscle-generated centripetal force is indicative of functional improvement.…”

Standard Correction of Vision Worsens EMG Activity of Pericranial Muscles in Chronic TMD Subjects

“…erefore, the characteristic of individuals with myogenic pain appear to be related to difficulties in adapting to variations in their visual input rather than absolute values of a single test or condition (e.g., eyes closed or open). In general, we propose that a relationship exists between refractive disorders, vision disorders, the stomatognathic system, and EMG hyperactivity, as described in a recent literature review [7]. It has been reported that the prevalence of vision disorders in the general population is high, and it is increasing in Europe and elsewhere worldwide [8,9].…”