The role of the sphenoid bone in the connection between the temporal-mandible-tongue-hyoid system and the cervical spine.

The cranio-cervical-mandibular system is a functional complex whose understanding has evolved significantly, moving from a purely mechanical model to an integrated view that includes myofascial and postural interdependencies. Recent studies, particularly the work of Messina, have led to the definition of the Temporal-Mandible-Tongue-Hyoid (TMTH) system, a biomechanical unit in which the temporal bone acts as a fulcrum. This article aims to analyze the often-underestimated role of the sphenoid bone as a key element of anatomical and functional connection between the TMTH system and the upper cervical spine. Through its direct articulations with the occiput and temporal bone, and its muscular connections with the mandible, the sphenoid emerges as a biomechanical bridge that may transmit and modulate forces between the stomatognathic system and the vertebral column, potentially influencing cranio-cervical posture. This perspective suggests that a holistic diagnostic and therapeutic approach, inclusive of the sphenoid, is crucial for effectively managing cranio-cervical-mandibular disorders.