Integrating occlusion, vision, and posture: a multidisciplinary approach to paediatric malocclusion

Abstract

CASE REPORT: This case report presents a comprehensive postural evaluation of a 9-year-old paediatric patient with unilateral right crossbite and an associated visual defect. Postural assessments were performed using a vertical laser line (VLL) and a baropodometric-stabilometric platform, revealing significant postural alterations, including cervical extension, increased dorsal kyphosis, pelvic rotation, and an asymmetrical distribution of plantar load. The Romberg test indicated a visual system dysfunction, confirmed by ophthalmologic and orthoptic examinations, which identified mild myopic astigmatism and convergence insufficiency. The patient underwent two years of treatment with the Mouth Slow Balance (MSB) functional appliance, combined with corrective lenses and orthoptic exercises. Post-treatment evaluations demonstrated substantial improvements, including correction of the crossbite, normalization of visual function, improved head and body posture, and balanced plantar load distribution. The Romberg Index returned to physiological values, confirming restored visual influence on postural control. This case underscores the importance of a multidisciplinary approach involving dental, postural, and ophthalmologic evaluations in addressing occlusal and visual dysfunctions. Early identification and intervention can prevent compensatory postural adaptations, optimise craniofacial growth, and enhance the overall quality of life in paediatric patients.