Objective of this study is to search an anatomical explanation to atlo-axial subluxation frequently observed during cranio-mandibular dysmorphisms. This clinical damage was recently discovered by means of 3D-CT in patients suffering from a lot of mandibular-facial disorders like laterodeviations, cross bite or hemimandibular elongation. Observing the two diarthrosical areas of the skull base (mandibular fossa and occipital condyle), the AA noriced that the two bony surfaces are quite somilar even if its shape is just opposite (hollow and convex) and the direction of its main axis different orientation. In this area of the skull they considered the gleno-occipiato-mastoid triangle to fully understand the rotatory movements to which both articular surfaces are simultaneously subjected at the two sides of the median line, dragging in this rotation the upper part of the cervical spine. The mastoid process in this area merits some particular considerations: a lot of muscles, in fact, attach to its surface and they also act very strongly, bringing the head to rotate ventrally toward to the sternum, dorsally toward the cervical spine and down towards the hyoid-mandibular complex. Well thinking over these opposite forces, the centre of gravity of the head become a very important point on which the attention of the physician must be focused. In fact, when the loss of the simmetry of the face displaces a lot of muscular and bony masses toward one side, a severe unbalance of all the head go on and this point is pulled away from the median line and from its ideal position. Therefore, before to start anyone therapeutic intervention (orthodontic or surgical one), the physician must calculate at the first the ideal position of the centre of gravity for that particular head and only by means of this physical lead he can select the best intervention to replace it as near as possible to its ideal position, so avoiding the stabilization of severe damages to the cervical spine.

Anatomical changes in craniomandibular disorders

CONTINENZA, Maria Adelaide;CUTILLI, Tommaso
1999-01-01

Abstract

Objective of this study is to search an anatomical explanation to atlo-axial subluxation frequently observed during cranio-mandibular dysmorphisms. This clinical damage was recently discovered by means of 3D-CT in patients suffering from a lot of mandibular-facial disorders like laterodeviations, cross bite or hemimandibular elongation. Observing the two diarthrosical areas of the skull base (mandibular fossa and occipital condyle), the AA noriced that the two bony surfaces are quite somilar even if its shape is just opposite (hollow and convex) and the direction of its main axis different orientation. In this area of the skull they considered the gleno-occipiato-mastoid triangle to fully understand the rotatory movements to which both articular surfaces are simultaneously subjected at the two sides of the median line, dragging in this rotation the upper part of the cervical spine. The mastoid process in this area merits some particular considerations: a lot of muscles, in fact, attach to its surface and they also act very strongly, bringing the head to rotate ventrally toward to the sternum, dorsally toward the cervical spine and down towards the hyoid-mandibular complex. Well thinking over these opposite forces, the centre of gravity of the head become a very important point on which the attention of the physician must be focused. In fact, when the loss of the simmetry of the face displaces a lot of muscular and bony masses toward one side, a severe unbalance of all the head go on and this point is pulled away from the median line and from its ideal position. Therefore, before to start anyone therapeutic intervention (orthodontic or surgical one), the physician must calculate at the first the ideal position of the centre of gravity for that particular head and only by means of this physical lead he can select the best intervention to replace it as near as possible to its ideal position, so avoiding the stabilization of severe damages to the cervical spine.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11697/34353
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