Abstract
Spontaneous Mandibular Migration (SMM) serves as concrete evidence supporting the validity of the Neuromuscular Theory as a functional-oriented diagnostic methodology. The unique ability to anticipate a mandibular repositioning after the orthodontist has established the proper occlusion is one of the defining features of neuromuscular orthodontics. To initiate this process, the first crucial step is to establish Mandibular Freedom (MF) by removing any hindrances to migration, commonly referred to as “walls” in neuromuscular jargon. Several clinical examples are presented below to illustrate this concept in detail. Once MF is achieved, the mandible can then spontaneously migrate to its optimal position. This process is closely monitored by the orthodontist, who may use various diagnostic tools, such as electromyography (EMG) and computerized mandibular scanning, to track the mandible movement accurately.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Silveira S. e.a., The increased prevalence of malocclusion in modern humans: an integrative review. EC Dent Sci. 2018;17:2097–107.
Mew M. Craniofacial dystrophy. A possible syndrome? Br Dent J. 2014;216(10):555–8.
Doraczynska-Kowalik A, et al. Genetic factors involved in mandibular prognathism. J Craniofac Surg. 2017;28:5.
Hartsfield Jr JK, Morford LA, Otero LM. Genetic factors affecting facial growth. Orthodontics-Basic Aspects and Clinical Considerations; Bourzgui, F., Ed, 2012: 125–152.
Kærn M, et al. Stochasticity in gene expression: from theories to phenotypes. Nat Rev Genet. 2005;6(6):451–64.
Jaenisch R, Bird A. Epigenetic regulation of gene expression: how the genome integrates intrinsic and environmental signals. Nat Genet. 2003;33(3):245–54.
Lerman MD. A revised view of the dynamics, physiology, and treatment of occlusion: a new paradigm. Cranio. 2004;22(1):50–63.
Tanaka EM, Sato S. Longitudinal alteration of the occlusal plane and development of different dentoskeletal frames during growth. Am J Orthod Dentofac Orthop. 2008;134(5):602e1-11. discussion 602-3
Fushima K, et al. Significance of the cant of the posterior occlusal plane in class II division 1 malocclusions. Eur J Orthod. 1996;18(1):27–40.
Nakasima A, et al. Hereditary factors in the craniofacial morphology of Angle's Class II and Class III malocclusions. Am J Orthod. 1982;82(2):150–6.
Balkhande PB, Lakkakula BVKS, Chitharanjan AB. Relationship between matrilin-1 gene polymorphisms and mandibular retrognathism. Am J Orthod Dentofac Orthop. 2018;153(2):255–61.e1
Lima Filho RM, Lima AC, de Oliveira Ruellas AC. Spontaneous correction of class II malocclusion after rapid palatal expansion. Angle Orthod. 2003;73(6):745–52.
Volk T, et al. Rapid palatal expansion for spontaneous Class II correction. Am J Orthod Dentofac Orthop. 2010;137(3):310–5.
Planas P. The Planas law for minimum vertical dimension. Rev Esp Parad. 1968;6(4):215–47.
Schiavoni R, Grenga V. Management of the Herbst splint appliance in Class II malocclusion with different growth pattern. Prog Orthod. 2009;10(1):48–57.
Kai S, et al. The significance of posterior open bite after anterior repositioning splint therapy for anteriorly displaced disk of the temporomandibular joint. Cranio. 1993;11(2):146–52.
Perez CV, et al. The incidence and prevalence of temporomandibular disorders and posterior open bite in patients receiving mandibular advancement device therapy for obstructive sleep apnea. Sleep Breath. 2013;17(1):323–32.
Tallents RH, et al. Occlusal restoration after orthopedic jaw repositioning. Cranio. 1986;4(4):369–72.
Clark W. Design and management of twin blocks: reflections after 30 years of clinical use. J Orthod. 2010;37(3):209–16.
Li P, et al. Severe Class II division 1 malocclusion in an adolescent patient, treated with a novel sagittal-guidance twin-block appliance. Am J Orthod Dentofac Orthop. 2016;150(1):153–66.
Hiyama S, et al. Neuromuscular and skeletal adaptations following mandibular forward positioning induced by the Herbst appliance. Angle Orthod. 2000;70(6):442–53.
Melgaco CA, et al. Immediate changes in condylar position after rapid maxillary expansion. Am J Orthod Dentofac Orthop. 2014;145(6):771–9.
Weinberg LA. Role of condylar position in TMJ dysfunction-pain syndrome. J Prosthet Dent. 1979;41(6):636–43.
Weinberg LA. An evaluation of occlusal factors in TMJ dysfunction-pain syndrome. J Prosthet Dent. 1979;41(2):198–208.
Weinberg LA, Lager LA. Clinical report on the etiology and diagnosis of TMJ dysfunction-pain syndrome. J Prosthet Dent. 1980;44(6):642–53.
Weinberg LA. The role of stress, occlusion, and condyle position in TMJ dysfunction-pain. J Prosthet Dent. 1983;49(4):532–45.
Shokri A, et al. Comparative assessment of condylar position in patients with temporomandibular disorder (TMD) and asymptomatic patients using cone-beam computed tomography. Dent Med Probl. 2019;56(1):81–7.
Owen AH 3rd. Orthodontic/orthopedic treatment of craniomandibular pain dysfunction. Part 3: anterior condylar displacement. Cranio. 1984;3(1):31–45.
Egermark-Eriksson I, Carlsson GE, Magnusson T. A long-term epidemiologic study of the relationship between occlusal factors and mandibular dysfunction in children and adolescents. J Dent Res. 1987;66(1):67–71.
da Silva CG, et al. Prevalence of clinical signs of intra-articular temporomandibular disorders in children and adolescents: a systematic review and meta-analysis. J Am Dent Assoc. 2016;147(1):10–18 e8.
Al-Khotani A, et al. Prevalence of diagnosed temporomandibular disorders among Saudi Arabian children and adolescents. J Headache Pain. 2016;17:41.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Savastano, F. (2023). Mandibular Freedom and Spontaneous Mandibular Migration (SMM). In: Neuromuscular Orthodontics. Springer, Cham. https://doi.org/10.1007/978-3-031-41295-0_9
Download citation
DOI: https://doi.org/10.1007/978-3-031-41295-0_9
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-41294-3
Online ISBN: 978-3-031-41295-0
eBook Packages: MedicineMedicine (R0)