Correction of the Maxillary Occlusal Plane Relieves Persistent Headache and Shoulder Stiffness

Abstract

It has been known for many years that deformations of the occlusal plane of the teeth cause indefinite symptoms such as headaches or stiffness of the shoulders. However, how the occlusal plane of the teeth should be corrected remains uncertain. The purpose of this study was to examine whether a correction of the deviation of the maxillary occlusal plane (MOP) from the center of dens of axis vertebrae (DAV) improves symptoms in patients having intractable headache or shoulder-stiffness. Forty patients who complained of dental abnormalities and persistent headache or shoulder-stiffness that had not responded to conventional medical treatment and 17 healthy controls were recruited. All subjects received a lateral cephalometric x-ray examination to measure a distance from the MOP and the center of DAV. In the healthy subjects, both the upper and the lower shift of the MOP from the center of DAV were minimal (the upper shift was 1 ± 2 [mean ± S.D.] mm and the lower shift was 4 ± 4 mm). By contrast, the patients had a significantly greater deviation of the MOP from the center of DAV. Dental adjustment treatment was performed in fourteen patients who had a substantial deviation of the MOP from the center of DAV. Those patients were asked about their symptoms which were scored using a point system and were compared before and after treatment. An adjustment procedure of the MOP passing through the DAV significantly relieved clinical symptoms in these patients (before 42.5 ± 34.4 vs after 7.0 ± 8.2, p < 0.01). Correction of the MOP passing through the near center of DAV might be effective in relieving clinical symptoms associated with dental deformities.