Inter-test coherence of the visual sensor in occluso-postural regulation:
clinical, electromyographic, and stabilometric study
Dr. Jean-Claude Combadazou, Dr. Constance Cuny, Prof. Florent Destruhaut
Abstract
Interactions among vision, posture, and mandibular function have long been
recognized, yet their quantitative correlations remain debated. The visual sensor
contributes to postural tone through vestibular and oculomotor pathways, but its direct
influence on mandibular regulation is difficult to isolate. This retrospective pilot study
aimed to assess the inter-test coherence between clinical, electromyographic (MAC1a),
and stabilometric (MAC3a) evaluations of the visual sensor within the MAC1–MAC3
occluso-postural protocol.
A total of 156 anonymized patient records from occlusodontic consultations were
analyzed following GDPR standards (EU 2016/679). The assessments included (1)
clinical functional tests with eyes open and closed, (2) surface EMG of the masseter
and anterior temporalis muscles, and (3) stabilometric analysis using a force platform.
Inter-test agreement was evaluated through Cohen’s κ and weighted κ statistics.
Weighted κ coefficients were 0.26 (MAC1a/Clinical), 0.01 (MAC3a/Clinical), and 0.00
(MAC3a/MAC1a), with apparent overlaps (0.79–0.84) but weak true concordance.
These results indicate a dissociation between neuromuscular, stabilometric, and clinical
integration levels.
The findings support the concept that the visual sensor indirectly influences mandibular
posture through multisensory integration rather than direct control. Clinical, EMG, and
stabilometric methods should therefore be viewed as complementary diagnostic tools.
Concordant results justify ophthalmologic or orthoptic referral, whereas discordance
underscores the dominant role of the occlusal sensor in posturo-mandibular regulation.
Keywords: Visual sensor, occlusion, posture, electromyography, stabilometry,
multisensory integration, functional dentistry.
Learning Objectives
- To evaluate the coherence between clinical, electromyographic (MAC1a), and
stabilometric (MAC3a) assessments of the visual sensor within occluso-postural
regulation. - To identify electromyographic patterns indicative of visual sensor dysfunction
and correlate them with stabilometric variations. - To determine whether the functional clinical test (eyes open/closed resistance
test) can serve as a reliable clinical indicator of visual sensor involvement in
postural regulation.