Review Article

Correlations between the Visual Apparatus and Dental Occlusion: A Literature Review

Table 3

Main results of the studies.

ArticleYear of publicationType of articleSample (number of subjects)Range of age Control group  
(yes/not)
Randomization  
(yes/not)
Mean results

1C. Holberg [3]2005Virtual experiment: 
A finite element model of the sphenoid
////During palatal expansion, due to lateral bending of the pterygoid processes, marked stress develops in the round and oval foramen regions and those of the superior orbital fissure, where fractures causing neural and vascular injury can occur

2Holberg and Rudzki-Janson [4]2006Virtual experiment: 
Cranial constructions from the CT data (computerized simulations)
////The superior orbital fissure and the optic foramen 
seem particularly affected by stress during the rapid palatal expansion procedure

3Habeeb et al. [5]2013Prospective clinical study28 children 
(17 M; 11 F) 
(mean 9.9 years)
7.8-12.8 years//An increase in the ocular interaxial distance between the two eyes of about 0.25 mm after treatment was reported in children who required rapid palatal expansion

4Monaco et al. [6]2006Case-control study10 myopic children 
+ 
10 subjects, matched by gender and age
7-13 yearsYes/There is a marked difference in tonic activity of temporal anterior muscles at open eyes between the myopic and the normal children

5Sharifi Milani et al. [7]1998Prospective controlled clinical study15 subjects, who had worn mandibular orthopaedic repositioning appliances 
+ 
15 subjects, matched by gender and age
YesNoAfter wearing a mandibular orthopaedic repositioning appliances for a while, there are some fluctuations in visual focusing

6Cuccia and Caradonna [8]2008Case-control study50 symptomatic subjects with bilateral TMJ disc displacement (13 M, 37 F; mean age, 28.84 +/- 8.22 years) 
+ 
50 asymptomatic volunteers with normal disc position (14 M, 36 F; mean age, 29.96 +/- 5.04 years).
18-40 yearsYes/Subjects with TMJ disc displacement had a statistically significant higher alteration in binocular function 
(reduction in convergence, and positive fusional vergence) compared with control subjects with normal disc positions

7Monaco et al. [9]2003Case-control study48 subjects (12 M and 36 F; average age 35) with Temporomandibular disorders (TMD) and muscular pain and/or dysfunction 
+ 
48 subjects, matched by gender and age
19-45 yearsYes/The TMD subjects presented a higher statistical percentage of ocular convergence defects, with respect to control subjects

8Monaco et al. [10]2004Case-control study60 children with functional mandibular latero-deviation 
+ 
60 healthy children matched by gender and age.
Yes/In children affected by mandibular laterodeviation, ocular convergence defects occurred in greater frequency with respect to control children

9Erturk and Dogan [11]1990Case-control study20 blind subjects, who had been totally blind since birth 
+ 
20 normal-sighted subjects, matched by gender and age
Yes/Bind children show a significant difference in head posture, and in craniofacial and dentoalveolar morphology: an increase in the mandibular angle and in vertical jaw relationships and a decrease in inclination of the mandibular incisors, with respect to normal-sighted persons

10Heikkinen et al. [12]2004Cross-sectional study1423 young American black and white children (with II class cusp sagittal relationship) 
(mean age: 8.5).
6-12 years//True right-sided children show a more symmetric occlusion (bilateral Angle I or II class) than non-right-sided children (unilateral Angle I or II class)

11Heikkinen et al. [13]2005Cross-sectional study1423 young American black and white children (with II class cusp sagittal relationship) 
(mean age: 8.5).
6-12 years//True right-sided children show less crossbite on the right side than children having non-right-sidedness in their functions, with the differences being statistically significant

12Bollero et al. [14]2017Cross-sectional study84 subjects (49 M, 35 F)7.3±1.7 years//A statistically significant correlation is reported between ocular motility disorders and unilateral cross-bite with midline deviation.

13Monaco et al. [15]2006Case control-study32 children with functional lateral deviation of mandible and oculo-extrinsic muscular tone disorders, randomly divided into two groups: study and control. In the study group the ocular defects were corrected upon the support of an electromyographic control (in the control group in a conventional way)8-12 yearsYesYesBoth groups showed a significant statistical increase of tonic activity at rest with eyes open in the anterior temporalis muscle. But a significant decrease of this value was observed only with ocular correction upon electromyographic control (in the study group).

14Monaco et al. [16]2013Cross-sectional evaluation1.326 patients classified as Class I, Class II, and Class IIInonoThe prevalence of myopia was higher in Class II malocclusions, while the prevalence of astigmatism and hyperopia was higher in Class I malocclusion. No significant difference in vision defects by sex was found.

15Monaco et al. [17]2012Cross-sectional evaluation292 selected subjectsnonoA statistical significant higher prevalence was found for subjects showing myopia in Class II division 1 malocclusion, while no other significant differences were found for prevalence in the other classes of malocclusions.

16Monaco et al. [18]2011Cross-sectional evaluation176 selected subjects39 study subjects with cross-bite 
+ 
137 control subjects without crossbite
nonoStatistically significant correlations were found between astigmatism and cross-bite, while no associations were found with other malocclusions. No gender influence was found for astigmatism or malocclusion.

17Monaco et al. [19]2011Cross-sectional evaluation176 selected subjects32 study subjects with hyperopia 
+ 
138 control subjects
nonoStatistically significant correlations were found between hyperopia and cross-bite while no associations were found with other malocclusions.

18Silvestrini-Biavati et al. [20]2013Cross-sectional evaluation605 selected subjects8-10 yearsnonoA prevalence of cases with an unphysiological gait was found in patients with overjet (14.70%) or overbite (14.87%), while the percentage of patients with normal occlusion that showed an unphysiological gait was 13.08%. Subjects with an open bite or deep bite showed a slightly different distribution of right or left dominant eyes.

19Caruso et al.
[21]
2018Cross-sectional evaluation36 
(21M, 13F;)
12±2 yearsnonoA statistically significant association between occlusal molar class II and exophoria (78.3% of subjects with molar class II have exophoria, p<0.05) and fusional amplitudes below the cut-off value (83.3%, p<0.05).