Dental Tribune India

Correlating rotated mandibles with back & knee pain

By Dr. Ajay Kakar
July 06, 2021

A study was carried out to evaluate the co-relation between mandibular rotations in patients with a history of mid back pain, lower back pain, and knee pain.

The human body is a complex interconnected network that can be observed and understood as an interactive interplay of various components, each playing its unique role in maintaining the functionality of the human body. Human observations have classified these components into various systems with their individual roles to play. A couple of key systems are the musculoskeletal system and the nervous system.

The musculoskeletal system has been very aptly described in the Smylist® concept as a spiders web running from the top of the head to the tip of the toes. Working in harmony with signals received from the nervous system, the muscles function by contracting and elongating at the required times to provide locomotion, the ability to eat, speak so on, and so forth.

Mandibular rotation is a condition that has been defined in the Smylist® concept as a mandible that is shifted from its ideal position due to an uneven rotation of the condyles in a horizontal, saggital, and vertical plane. This rotation may be in any one plane or in more than one plane. The Smylist® concept is a creation of Dr. Maria Csillag which addresses dento-facial aesthetics as well as dental function in a very new and unique fashion. The concept also explains how the origin of a  variety of systemic situations is due to a “rotated mandible”. This study was done to find the prevalence of such conditions concerning mid and lower back pain and kneed pain.

The study obtained data from 48 subjects in the form of face photographs, photographs of the position of the feet after the Smylist® three jump test, and a detailed Smylist® history form. The face photographs were evaluated and the mandibular rotations were determined and the diagnosis was carried out based on the Smylist® concept. This was then cross-checked with the foot position photographs and the mandibular rotations confirmed. The foot positions were documented only after the three-jump test,  which brings the feet into their natural position.

This study confirms that the representative foot positions discrepancy is seen in all mandibular rotation cases as postulated by the Smylist® concept. All 48 cases demonstrated the mandibular rotation of varying severities and all of them reported varying degrees of one or more of the three categories of pain. The study definitely demonstrates the co-relation between mandibular rotation and foot position discrepancy which leads to posture compensations of various forms leading to mid-back, low back, and knee pain.

Link to the study: Co-relation between Rotated Mandibles and Back and Knee Pain


Jay Patel1, Aishwarya Mahajan2, Ajay Kakar3* and Maria Csillag4
1Principal Investigator, Nashik, India
2Investigator, Nashik India
3Guide, Mumbai, India
4Guide and Creator of the Smylist® Concept, Aesthetic Dentist, Budapest, Hungary

*Corresponding Author: Ajay Kakar, Guide, Periodontology, Mumbai, India.


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