Mandibular rest position: a reliable position influenced by head support and body posture.
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This prospective study was designed to establish how the positions of the molars and the condyles are related to incisor position in the mandibular rest position and how their positions are altered by changing head posture. Measurements of the mandibular rest position were taken on 24 men (age range, 23 to 35) with normal Class I occlusion, skeletal patterns, and temporomandibular joint function. The movements of 5 landmarks (lower incisor, and condyles and molars bilaterally) were tracked from maximum intercuspation into 4 independent rest positions (upright supported, upright unsupported, supine supported, and supine unsupported) using an optoelectric (Optotrak; Northern Digital, Waterloo, Ontario, Canada) computer system. The positions were based on minimal electromyographic and verbal instructions to swallow, lick the lips, and say "Mississippi." The results showed significant (P <.01) movements of the incisors, the molars, and the condyles into each of the 4 rest positions. Movements of the molars and the condyles into the supported upright posture and the unsupported upright posture differed slightly but significantly because of greater movement into the supported posture. Patterns of mandibular movement were entirely different between the upright and the supine rest positions; the mandible rotated anteriorly in the supine position and posteriorly in the upright position. We concluded that movement into the mandibular rest position from the intercuspal position is not a simple opening rotation of the mandible, and that the pattern of movement is influenced by head support and body postures.