RELATIONSHIP BETWEEN STOMATOGNATHIC SYSTEM ALIGNMENT AND CRANIOMANDIBULAR DYSFUNCTION: MECHANISMS, REHABILITATION STRATEGIES, AND CLINICAL OUTCOMES

Abstract

Craniomandibular dysfunction (CMD) is a multi-factorial disorder affecting the temporomandibular joint, masticatory muscles, occlusion, cervical spine and related neuromuscular structures. Alterations in stomatognathic alignment may contribute to CMD through complex biomechanical, postural, neurological, and psychosocial mechanisms. This review discusses stomatognathic system alignment and the influence of it on CMD, including pathophysiological mechanisms, diagnostic methods, rehabilitation interventions, and clinical results. There are indications that the abnormal occlusion, muscular hyperactivity, cervical postural dysfunction and parafunctional habits can compromise the biomechanics of the mandible and add stress to structures of the TMJ. Neurological mechanisms (trigemino-cervical convergence, central sensitization) also play a role in chronic pain and functional impairment. Comprehensive clinical examination, with the help of imaging and standardized diagnostic criteria such as RDC/TMD and DC/TMD, is required for diagnostic evaluation. Various conservative multi-disciplinary rehabilitative strategies have proven to be effective for reducing pain and enhancing mandibular function and quality of life, such as occlusal therapy, physiotherapy, neuromuscular rehabilitation, and psychosocial management. But there is some controversy about direct causal involvement of occlusal and postural factors because of heterogeneity in the available literature. Overall, CMD should be considered a complex biopsychosocial disorder requiring individualized and multidisciplinary management strategies.

Keywords: Craniomandibular dysfunction, Temporomandibular disorders, Stomatognathic system, Occlusion, Rehabilitation