Impaired supporting function of the feet in adolescents with congenital cleft lip and palate with a mesial ratio of dentition

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Abstract

BACKGROUND: Impaired occlusal relationships of dental rows can cause adaptive changes in the entire musculoskeletal system, including the feet. Thus, studying the biomechanics of the feet with the possibility of changing the medical rehabilitation program of patients with dentomaxillofacial anomalies of various geneses is important.

AIM: To investigate the plantographic characteristics of the feet in adolescents with congenital cleft lip and palate and combined dentomaxillofacial anomaly with a mesial ratio of dental rows and analyze patterns of distribution of plantar pressure before and after reconstructive operations on the jaws and restoration of facial harmony.

MATERIALS AND METHODS: The study included 31 patients of both sexes aged 15–17 years, who were divided into two groups. The first group consisted of 15 patients with congenital cleft lip and palate after the early stages of reconstructive surgery (cheilorhinoplasty and uranoplasty) and developed a combined dentomaxillofacial anomaly. The second group, with milder lesion, included 16 patients with combined dentomaxillofacial anomaly and do not have congenital cleft lip and palate. Patients had skeletal forms of mesial ratios of dental rows. To correct the bite and restore the aesthetics of the face, all patients underwent simultaneous bone reconstructive (“orthognathic”) surgery on the upper and lower jaws, including genioplasty in some of them, to restore the normal relationship of the jaw bones and harmonize the face. The plantographic characteristics of the feet were studied in patients before surgery and 1–6 months after surgery. The results of these two groups were compared with a pantographic examination of 18 healthy children (control group) without these pathologies in the maxillofacial region and without impairment of the supporting function of the foot.

RESULTS: The first and second groups had a significant decrease in the indices of support on both feet before surgery: t, up to 85 (normal, 96); m, up to 16 (normal, 23); and s, up to 20 (normal, 24), which indicate a decrease in the spring function of the transverse and longitudinal arches and impairment of the supporting function of the feet. It was most pronounced in patients with congenital cleft lip and palate. Deviations in the magnitude of the Clark angle α were multidirectional on the left and right feet, which indicated an abnormally high asymmetry of the load distribution between the feet. Functional relationships between the foot arches were pathologically enhanced to values of rs = 0.83 (normal, rs = 0.14), which indicated a formed pathological support strategy of the feet. After reconstructive operations on the jaws, the biomechanics of the feet in patients with combined dentomaxillofacial anomaly (without congenital cleft lip and palate) tended to normalize.

CONCLUSIONS: It is necessary to consider the possible aggravating effect of the feet with a modified support strategy on the condition of the dentofacial area. Moreover, the comprehensive diagnosis plan of adolescents with congenital cleft lip and palate and combined dentomaxillofacial anomaly and combined dentomaxillofacial anomaly (without congenital cleft lip and palate) should include a study of the supporting function of the feet, considering rehabilitation measures to correct the distribution of plantar pressure.

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About the authors

Igor E. Nikityuk

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Author for correspondence.
Email: femtotech@mail.ru
ORCID iD: 0000-0001-5546-2729
SPIN-code: 5901-2048
Scopus Author ID: 57190070174

MD, PhD, Cand. Sci. (Med.)
Russian Federation, Saint Petersburg

Mikhail G. Semenov

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery; North-Western State Medical University named after I.I. Mechnikov

Email: sem_mikhail@mail.ru
ORCID iD: 0000-0002-1295-1554
SPIN-code: 2603-1085
Scopus Author ID: 57193276067

MD, PhD, Dr. Sci. (Med.), Professor

Russian Federation, Saint Petersburg; Saint Petersburg

Sofia A. Botsarova

North-Western State Medical University named after I.I. Mechnikov

Email: Dr.Botsarova@mail.ru
ORCID iD: 0000-0002-4675-8517
SPIN-code: 4930-8561

MD, resident

Russian Federation, Saint Petersburg

References

  1. Isaia B, Ravarotto M, Finotti P, et al. Analysis of dental malocclusion and neuromotor control in young healthy subjects through new evaluation tools. J Funct Morphol Kinesiol. 2019;4:5. doi: 10.3390/jfmk4010005
  2. Silveira A, Armijo-Olivo S, Gadotti IC, Magee D. Masticatory and cervical muscle tenderness and pain sensitivity in a remote area in subjects with a temporomandibular disorder and neck disability. J Oral Facial Pain Headache. 2014;28(2):138−146.
  3. Cuccia AM. Interrelationships between dental occlusion and plantar arch. J Bodyw Mov Ther. 2011;15(2):242–250.
  4. Souza JA, Pasinato F, Correa EC, Silva AM. Global body posture and plantar pressure distribution in individuals with and without temporomandibular disorder: a preliminary study. J Manipulative Physiol Ther. 2014;37(6):407−414.
  5. Ishizawa T, Xu H, Onodera K, Ooya K. Weight distributions on soles of feet in the primary and early permanent dentition with normal occlusion. J Clin Pediatr Dent. 2006;30:165–168. doi: 10.17796/jcpd.30.2.8x4727137678061m
  6. Cabrera-Domínguez ME, Domínguez-Reyes A, Pabón-Carrasco M, et al. Dental malocclusion and its relation to the podal system. Front Pediatr. 2021;22(9):654229. doi: 10.3389/fped.2021.654229
  7. Scharnweber B, Adjami F, Schuster G, et al. Influence of dental occlusion on postural control and plantar pressure distribution. Cranio. 2017;35(6):358−366. doi: 10.1080/08869634.2016.1244971
  8. Ciuffolo F, Ferritto AL, Muratore F, et al. Immediate effects of plantar inputs on the upper half muscles and upright posture: a preliminary study. Cranio. 2006;24(1):50−59. doi: 10.1179/crn.2006.009
  9. Semenov MG, Botsarova SA, Stepanova YV. Analysis of bone-reconstructive surgery aimed at normalization of occlusal relationships of the jaws at the final stages of rehabilitation treatment of children with congenital cleft lips and palate (literature review). Pediatric traumatology, orthopaedics and reconstructive surgery. 2021;9(3):377–387. (In Russ.). doi: 10.17816/PTORS64936
  10. Perepelkin AI, Mandrikov VB, Krayushkin AI. The effect of metered load on the change in the structure and function of the human foot. Volgograd: VolgGMU; 2012. (In Russ.)
  11. Mukhra R, Krishan K, Kanchan T. Bare footprint metric analysis methods for comparison and identification in forensic examinations: A review of literature. J Forensic Leg Med. 2018;58:101−112. doi: 10.1016/j.jflm.2018.05.006
  12. Nikityuk IE, Vissarionov SV. Foot function disorders in children with severe spondylolisthesis of L5 vertebra. Traumatology and orthopedics of Russia. 2019;25(2):71−80. (In Russ.). doi: 10.21823/2311-2905-2019-25-2-71-80
  13. Zifchock RA, Davis I, Hillstrom H, Song J. The effect of gender, age, and lateral dominance on arch height and arch stiffness. Foot Ankle Int. 2006;27(5):367−372. doi: 10.1177/107110070602700509
  14. Nirenberg MS, Ansert E, Krishan K, Kanchan T. Two-dimensional metric comparisons between dynamic bare footprints and insole foot impressions-forensic implications. Sci Justice. 2020;60(2):145−150. doi: 10.1016/j.scijus.2019.12.001
  15. Schorderet C, Hilfiker R, Allet L. The role of the dominant leg while assessing balance performance. A systematic review and meta-analysis. Gait Posture. 2021;84:66−78. doi: 10.1016/j.gaitpost.2020.11.008
  16. Paillard T, Noé F. Does monopedal postural balance differ between the dominant leg and the non-dominant leg? A review. Hum Mov Sci. 2020;74:102686. doi: 10.1016/j.humov.2020.102686
  17. Rosende-Bautista C, Munuera-Martínez PV, Seoane-Pillado T, et al. Relationship of body mass index and footprint morphology to the actual height of the medial longitudinal arch of the foot. Int J Environ Res Public Health. 2021;18(18):9815. doi: 10.3390/ijerph18189815
  18. Nikityuk IE, Kononova EL, Semyonov MG. Features of the support function of feet in children with congenital abnormalities and acquired deformities of the mandibular bones. Human Physiology. 2018;44(5):39–46. (In Russ.). doi: 10.1134/S0131164618050119
  19. Gonzalez-Martin C, Pita-Fernandez S, Seoane-Pillado T, et al. Variability between Clarke’s angle and Chippaux-Smirak index for the diagnosis of flat feet. Colomb Med (Cali). 2017;48(1):25−31.
  20. Marchena-Rodríguez A, Moreno-Morales N, Ramírez-Parga E, et al. Relationship between foot posture and dental malocclusions in children aged 6 to 9 years: A cross-sectional study. Medicine. 2018;97(19):e0701. doi: 10.1097/MD.0000000000010701
  21. González-Rodríguez S, Llanes-Rodríguez M, Pedroso-Ramos L. Modifications of the dental occlusion and its relation with the body posture in Orthodontics. Bibliographic review. Rev Haban Cines Med. 2017;16:371–386.
  22. Novo MJ, Changir M, Quirós A. Relación de las alteraciones plantares y las maloclusiones dentarias en niños. Rev Latinoam Ortod Odontop. 2013;32:1–35.
  23. Pérez-Belloso AJ, Coheña-Jiménez M, Cabrera-Domínguez ME, et al. Influence of dental malocclusion on body posture and foot posture in children: a cross-sectional study. Healthcare. 2020;8(4):485. doi: 10.3390/healthcare8040485
  24. Kim J, Park BY, Mun SJ, et al. Differences in plantar pressure by REBA scores in dental hygienists. Int J Dent Hyg. 2019;17(2):177−182. doi: 10.1111/idh.12375
  25. Birinci T, Demirbas SB. Relationship between the mobility of medial longitudinal arch and postural control. Acta Orthop Traumatol Turc. 2017;51(3):233−237. doi: 10.1016/j.aott.2016.11.004
  26. Sadeghi H, Allard P, Prince F, Labelle H. Symmetry and limb dominance in able-bodied gait: a review. Gait Posture. 2000;12(1):34−45. doi: 10.1016/s0966-6362(00)00070-9
  27. Milenković S, Paunović K, Kocijančić D. Laterality in living beings, hand dominance, and cerebral lateralization. Srp Arh Celok Lek. 2016;144(5−6):339.
  28. Nikityuk IE, Garkavenko YE, Kononova ЕL. Special aspects of the support function of lower limbs in children with the consequences of unilateral lesion of the proximal femur with acute hematogenous osteomyelitis. Pediatric traumatology, orthopaedics and reconstructive surgery. 2018;6(1):14–22. (In Russ.). doi: 10.17816/PTORS5349-57
  29. Amaricai E, Onofrei RR, Suciu O, et al. Do different dental conditions influence the static plantar pressure and stabilometry in young adults? PLoS One. 2020;15(2):e0228816. doi: 10.1371/journal.pone.0228816
  30. Iacob SM, Chisnoiu AM, Buduru SD, et al. Plantar pressure variations induced by experimental malocclusion – a pilot case series study. Healthcare. 2021;9(5):599. doi: 10.3390/healthcare9050599
  31. Lin CS. Meta-analysis of brain mechanisms of chewing and clenching movements. J Oral Rehabil. 2018;45(8):627−639. doi: 10.1111/joor.12657
  32. Lotze M, Lucas C, Domin M, Kordass B. The cerebral representation of temporomandibular joint occlusion and its alternation by occlusal splints. Hum Brain Mapp. 2012;33(12):2984−2993. doi: 10.1002/hbm.21466
  33. Feng CZ, Li JF, Hu N, et al. Brain activation patterns during unilateral premolar occlusion. Cranio. 2019;37(1):53−59. doi: 10.1080/08869634.2017.1379259
  34. Kurchaninova MG, Skvortsov DV, Baklushin AE, et al. The influence of disturbed functions of the temporomandibular joint on postural balance. Physical therapy and sports medicine. 2016;137(5):46–50. (In Russ.)
  35. Yoshino G, Higashi K, Nakamura T. Changes in weight distribution at the feet due to occlusal supporting zone loss during clenching. Cranio. 2003;21:271−278.
  36. Bugrovetskaya OG, Maksimova EA, Kim KS. Differential diagnostics of pathways of the development of postural disorders in case of the TMJ dysfunction (a posturological study). J Manual’naya terapiya. 2016;1:3–13. (In Russ.)
  37. Bachu AYa. Enhancement of sensory-motor integration in the neocortex by reflexogenic stimulation of physiologically active zones. Bulletin of the Pridnestrovian University. Series: Medical-biological and chemical sciences. 2014;2:112–117. (In Russ.)
  38. Valentino B, Melito F, Aldi B, Valentino T. Correlation between interdental occlusal plane and plantar arches. An EMG study. Bull Group Int Rech Sci Stomatol Odontol. 2002;44(1):10−13.
  39. Marini I, Bonetti GA, Bortolotti F, et al. Effects of experimental insoles on body posture, mandibular kinematics and masticatory muscles activity. A pilot study in healthy volunteers. J Electromyogr Kinesiol. 2015;25(3):531–539. doi: 10.1016/j.jelekin.2015.02.001

Supplementary files

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1. Fig. 1. Appearance and computed tomography of the skull of group 1 and 2 patients before osteoreconstructive surgeries on the jaws: a, patient S., 16 years old, with congenital cleft lip and palate and combined dentomaxillofacial anomaly after staged cheilorhinoplasty and uranoplasty; b, patient K., 16 years old, with combined dentofacial anomaly (without congenital cleft lip and palate)

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2. Fig. 2. Appearance and computed tomography of the skull of patient Z., 17 years old, with congenital cleft lip and palate and combined dentomaxillofacial anomaly before (a) and 3 months after (b) LeFort I maxillary osteotomy, bilateral retromolar sagittal mandibular osteotomy, and genioplasty

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3. Fig. 3. Plantographic examination of the patients: a, scanning of the plantar surface of the feet; b, calculation of plantogram linear parameters; c, calculation of the angular parameter of the plantogram, Clarke’s angle (α)

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4. Fig. 4. Plantograms of the feet of patient K., 17 years old, with a combined dentomaxillofacial anomaly (without congenital cleft lip and palate): a, before the surgery, the support ability of the head of metatarsal bone I is reduced on both sides, more on the right (supination rigidity of the forefoot); b, one month after the surgery, the support ability of the head of metatarsal bone I on both sides improved (supination rigidity of the forefoot was eliminated)

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5. Fig. 5. Computer statokinesiograms: a, healthy adolescent, 16 years old; b, patient F., 17 years old, with congenital cleft lip and palate, combined dentomaxillofacial anomaly, pronounced disposition of the patient’s real center of pressure in relation to the absolute center posteriorly before surgery; c, the same patient after surgery, a significant displacement of the real center of pressure of the adolescent anteriorly into the projection of the absolute center. The red line is the test with eyes open, and the green line is with eyes closed

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6. Fig. 6. Regression line (bold) and its confidence interval (thin lines) to assess the relationship between the medial m and median s support indices of the left foot with a double-support load: a, in the healthy group; b, in patients with congenital cleft lip and palate and combined dentomaxillofacial anomaly after the surgery

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Copyright (c) 2022 Nikityuk I.E., Semenov M.G., Botsarova S.A.

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