Radiographic evaluation of cervical spine of subjects with temporomandibular joint internal disorder

Abstract

Although the etiopathophysiology of internal temporomandibular joint internal disorders (TMJ ID) is still unknown, it has been suggested that head and body posture could be related to its initial onset, development and perpetuation. The purpose of the present study was to observe the relationship between cervical spine X-ray abnormalities and TMJ ID. This investigation evaluated 30 subjects with internal TMJ disorder symptoms (test group) and 20 healthy subjects (control group). Subjects were submitted to clinical and radiographic evaluation. Clinical evaluation comprised anamnesis and stomatognathic system physical examination. Radiographic evaluation comprised analysis of lateral cervical spine X-rays by three physical therapists and tracing on the same images. The test group presented twice as much cervical spine hyperlordosis as the control group (20.7% versus 10.5%), but almost half of rectification prevalence (41.4 versus 79.0%, p = 0.03). After that, the test group was divided into three subgroups according to TMJ dysfunction severity, evaluated by Helkimo's index. These subgroups were not significantly different, but the subgroup with more severe TMD showed a tendency to cervical spine hyperlordosis prevalence. Results showed a tendency for subjects with more severe TMD to exhibit cervical spine hyperlordosis. Nevertheless, studies with a larger number of subjects suffering from severe TMD are encouraged in order to corroborate the present findings. DESCRIPTORS: Temporomandibular joint disorders; Spinal column; Radiography; Posture. RESUMO:Apesar de a etiofisiopatologia dos distúrbios internos (DI) da articulação temporomandibular (ATM) ser ainda desconhecida, sugere-se que as posturas de cabeça e corpo estariam associadas a seu desencadeamento, desenvolvimento e sua perpetuação. O objetivo deste estudo foi verificar a relação entre alterações radiográficas de coluna cervical e distúrbios internos da ATM. Este estudo avaliou 30 indivíduos com distúrbios da ATM (grupo teste) e 20 saudáveis (grupo controle). Os indivíduos submeteram-se à avaliação clínica e radiográfica. A avaliação clínica consistiu de anamnese e exame físico do sistema estomatognático. A avaliação radiográfica consistiu de análise de radiografias laterais de coluna cervical por fisioterapeutas e traçados. O grupo teste apresentou o dobro da prevalência de hiperlordose de coluna cervical (20,7% versus 10,5%) e quase a metade (41,4% versus 79,0%) de retificação (p = 0,03). Em um segundo momento, o grupo teste foi subdividido em três subgrupos em função da gravidade clínica da disfunção temporomandibular, avaliada pelo índice de Helkimo. Não houve diferença estatisticamente significante entre os subgrupos, mas se constatou uma tendência do subgrupo com disfunção grave a apresentar prevalência de hiperlordose cervical. Esses resultados sugerem uma tendência dos indivíduos com disfunção temporomandibular (DTM) grave a apresentarem hiperlordose. No entanto, futuros estudos devem ser feitos, analisando-se um maior número de indivíduos...

Association between temporomandibular disorders and abnormal head postures

“…These methods may lead to positive findings in the comparison between head position and temporomandibular dysfunction. 2,14,15 However, no validation or reliability tests have been used for most methods. In contrast, the craniovertebral angle used in our study to evaluate forward head posture is a highly reliable measurement.…”

“…Most studies 2,9,13,14,15,20,23 have analyzed only head protrusion in the sagittal plane but the head also moves in the frontal planes, which results in head tilts, and in the transverse plane, which results in rotations. Therefore, it may be inferred that imbalances may exist in tilt and rotation.…”

“…Attempts to establish a correlation between variables, particularly the cervical posture and head posture, have yielded contradictory results. Head posture has been studied by several authors, most often in association with craniocervical changes, 1 temporomandibular disorders (TMD), 2 mandibular development and function, 1,3,4 type of occlusion, 5 …”

Somatic Tinnitus

“…However, after treating the TMJ disorder, a reduction in modulation following somatic maneuvers in the NECK region was found. This could be explained by the possible effect of the TMJ disorder on the NECK ascending pathways, resulting in a modulation in this region as well [91][92][93][94] . This suggests to carefully evaluate the somatic component, especially when a notable history of TMJ dysfunction is suspected and no other significant risk factors are present.…”

Efeito de três intervenções de fisioterapia comparadas a tratamento odontológico em indivíduos com bruxismo: um ensaio clínico randomizado

“…[4,57,70,80] Para avaliação da curvatura da coluna cervical para identificação da lordose fisiológica, hiperlordose ou retificação, foram realizadas radiografias digitalizadas da coluna cervical em perfil lateral, de acordo com critérios propostos na literatura. [82,131,[133][134][135]  Variáveis primárias…”