Gait and posture analysis in patients with maxillary transverse discrepancy, before and after RPE

Martina Mason; Fabiola Spolaor; Annamaria Guiotto; Alberto De Stefani; Antonio Gracco; Zimi Sawacha

doi:10.1016/j.ortho.2018.01.003

Gait and posture analysis in patients with maxillary transverse discrepancy, before and after RPE

Int Orthod. 2018 Mar;16(1):158-173. doi: 10.1016/j.ortho.2018.01.003. Epub 2018 Feb 14.

Authors

Martina Mason¹, Fabiola Spolaor², Annamaria Guiotto², Alberto De Stefani³, Antonio Gracco¹, Zimi Sawacha²

Affiliations

¹ Department of neuroscience, School of Dentistry, University of Padua, Via Giustiniani 5, 35128 Padova, Italy.
² Department of engineering, University of Padua, Italy.
³ Department of neuroscience, School of Dentistry, University of Padua, Via Giustiniani 5, 35128 Padova, Italy. Electronic address: alberto.de.stefani@hotmail.it.

PMID: 29452908
DOI: 10.1016/j.ortho.2018.01.003

Abstract

Aim: The purpose of this study was to evaluate the effects of the rapid palatal expansion (RPE) on posture and gait analysis in subjects with maxillary transverse discrepancies.

Material and methods: Forty-one patients between 6 and 12 years were divided into 3 groups: 10 control subjects (Cs), 16 patients with unilateral posterior crossbite (CbMono), 15 patients with maxillary transverse discrepancy and no crossbite (Nocb). Every subject underwent gait analysis and posturographic examination in order to evaluate the presence of balance alterations before (T0) and after (T4) RPE application. The examinations were performed through a six-cameras stereophotogrammetric system (60-120Hz, BTS S.p.A.) synchronized with two force plates (FP4060, Bertec Corp.). Romberg test was performed on a force plate, and the statokinesiogram and joint kinematics were evaluated. One-way Anova was performed among the variables after evidence of normal distribution (Levene's test for equality of variances) and Kruskal-Wallis test (P<0.05), in order to compare the three groups of subjects. While paired t-test was performed, or Kruskal-Wallis test, instead when comparing pre- and post-RPE application within the same group of subjects (P<0.05). Tamane T2 or Bonferroni correction was applied where needed.

Results: The posturographic analysis reveal significant differences across the 3 population: 95% power frequency in medio-lateral and antero-posterior direction in T0, median frequency in medio-lateral direction in T0, mean power frequency in medio-lateral direction in T0. Significant differences were also registered in the three-dimensional joints kinematics variables, mainly between Cs and Cbmono in T0 and T4 and between Cbmono and Nocb in T4.

Conclusions: A detectable correlation between dental occlusion and body posture is shown in this study that confirms another benefit of the RPE. This was mainly revealed in the dynamic posture where modifications at the mandibular level affect the whole body.

Keywords: Balance; Gait analysis; Maxillary transverse discrepancy; Posterior unilateral crossbite; Posture.

MeSH terms

Biomechanical Phenomena
Child
Female
Gait Analysis*
Humans
Male
Malocclusion / physiopathology
Malocclusion / therapy*
Palatal Expansion Technique*
Photogrammetry
Posture*
Time and Motion Studies