Effects of remote facilitation on ankle joint movement: Focusing on occlusal strength and balance

Background: Remote facilitation refers to teeth occlusion-activated spinal cord activity resulting in increased trunk and limb muscle strength. Facilitation depends on dentition-related pressure during occlusion and masticatory muscle contraction strength.

Aims: This study aimed to clarify the neurophysiological phenomenon and mechanisms by which occlusal strength and balance affect leg muscle activity and smooth joint movement execution.

Materials & methods: To examine occlusal strength, three conditions were set: no contact between teeth and Moderate- and Maximum-strength occlusion (No-bite, Moderate, and Max conditions, respectively). To assess occlusal balance, we measured occlusal forces and calculated the left-right force ratio. We designated the sides with higher and lower occlusal pressure as hypertonic and hypotonic, respectively. We assessed ankle dorsiflexion movements with joint movement and isometric tasks.

Results: The rate of joint development and peak ankle dorsiflexion torque were significantly higher under occlusion (moderate and max compared to No-bite conditions), and the joint movement performance time was significantly shorter under Moderate compared to No-bite conditions. The joint movement execution time change rate from No-bite to Moderate condition was significantly lower on the Hypertonic side. Joint movement function was most improved under Moderate conditions.

Discussion: While remote facilitation improves with higher occlusal strength, leading to increased muscle strength, there is optimal occlusion intensity in joint movement. Moreover, an occlusal balance-dependent imbalance exists in remote facilitation between the Hyper- and Hypotonic sides.

Conclusion: Thus, low-intensity occlusion is optimal for smooth joint movement, and unbalanced occlusion results in asymmetrical motor function facilitation.