Aims: The atlo-occipital and atlo-axioid articular system, that realize the junction between occipital bone and cervical spine was studied in subjects with mandibular asimmetry to assess anatomical and clinical atlo-axioid-occipital disorders. Method: The research was carried out on 25 subjects affected by different degrees of mandibular asimmetry, of which 16 males and 9 females, of ages between 18 and 25 years. In this study cases of combined maxillomandibular asimmetry were not taken into consideration. The study was carried out using high-resolution CT of the maxillofacial region and atlo-axioid-occipital junction, combined with 3D-CT. Study of the soft tissues was executed using MR. Results: Significant modifications of the trim of the atlo-epistriphic articulation were observed in the investigated subjects. In particular: 1) A costant modification of the relation between the atlo-axioid and the atlo-occipital articultaions. 2) The atlas was counter-rotated with respect to upper maxilla. 3) Consequently, there is a costant degree of subluxation of the faces of the atlo-occipital articulations. 4) The atlas rotation follows the deviation and the direction of the mandibular asimmetry. 5) The axis of the epistropheus is subluxated on the side of the atlas rotation and seems to be displaced on the same side. This aspect can also be evaluated using MR imaging wich shows it in front of atlo-epistrophic (transversal) ligament. Conclusions: The AA believe that these articular modifications represent a muscular-skeletric compensation in response to postural craniomaxillofacial modifications subsequent to mandibular asimmetry. These modifications explane the even severe occipito-cervical algias and arthrosic processes of the vertebral column.

Atlo-axioid-occipital junction derangement in the mandibular asimmetry.

CUTILLI, Tommaso
1998-01-01

Abstract

Aims: The atlo-occipital and atlo-axioid articular system, that realize the junction between occipital bone and cervical spine was studied in subjects with mandibular asimmetry to assess anatomical and clinical atlo-axioid-occipital disorders. Method: The research was carried out on 25 subjects affected by different degrees of mandibular asimmetry, of which 16 males and 9 females, of ages between 18 and 25 years. In this study cases of combined maxillomandibular asimmetry were not taken into consideration. The study was carried out using high-resolution CT of the maxillofacial region and atlo-axioid-occipital junction, combined with 3D-CT. Study of the soft tissues was executed using MR. Results: Significant modifications of the trim of the atlo-epistriphic articulation were observed in the investigated subjects. In particular: 1) A costant modification of the relation between the atlo-axioid and the atlo-occipital articultaions. 2) The atlas was counter-rotated with respect to upper maxilla. 3) Consequently, there is a costant degree of subluxation of the faces of the atlo-occipital articulations. 4) The atlas rotation follows the deviation and the direction of the mandibular asimmetry. 5) The axis of the epistropheus is subluxated on the side of the atlas rotation and seems to be displaced on the same side. This aspect can also be evaluated using MR imaging wich shows it in front of atlo-epistrophic (transversal) ligament. Conclusions: The AA believe that these articular modifications represent a muscular-skeletric compensation in response to postural craniomaxillofacial modifications subsequent to mandibular asimmetry. These modifications explane the even severe occipito-cervical algias and arthrosic processes of the vertebral column.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11697/34349
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