Craniocervical and Cervical Spine Features of Patients with Temporomandibular Disorders: A Systematic Review and Meta-Analysis of Observational Studies

Abstract

To assess neck disability with respect to jaw disability, craniocervical position, cervical alignment, and sensorimotor impairments in patients with temporomandibular disorders (TMD), a systematic review and meta-analysis of observational studies trials were conducted. The meta-analysis showed statistically significant differences in the association between neck disability and jaw disability (standardized mean difference (SMD), 0.72 (0.56–0.82)). However, results showed no significant differences for cervical alignment (SMD, 0.02 (−0.31–0.36)) or for the craniocervical position (SMD, −0.09 (−0.27–0.09)). There was moderate evidence for lower pressure pain thresholds (PPT) and for limited cervical range of motion (ROM). There was limited evidence for equal values for maximal strength between the patients with TMD and controls. There was also limited evidence for reduced cervical endurance and conflicting evidence for abnormal electromyographic (EMG) activity and motor control in TMD patients. Results showed a clinically relevant association between cervical and mandibular disability in patients with TMD. Regarding sensory-motor alterations, the most conclusive findings were observed in the reduction of PPT and cervical ROM, with moderate evidence of their presence in the patients with TMD. Lastly, the evidence on impaired motor control and cervical EMG activity in patients with TMD was conflicting.

Role of Photobiomodulation Therapy in Modulating Oxidative Stress in Temporomandibular Disorders. A Systematic Review and Meta-Analysis of Human Randomised Controlled Trials

“…This is due to an altered neuro-biomechanical function of the cervical spine, which can apply stress on the TMJ, causing TMD. There is evidence to support that the craniomandibular region and upper cervical spine are related from anatomical, biochemical and neurophysiological standpoints [113,114], due to a neuroanatomical link between the orofacial and cervical regions, as well changes in the isometric strength of cervical flexors, according to the bite position of TMD patients [115,116]. Hence, the manual muscle test (MMT) is a reliable and useful clinical diagnostic tool for cervical muscles assessment to be considered [117].…”

Orthodontic Treatment and Craniocervical Posture in Patients with Temporomandibular Disorders: An Observational Study

“…This monitoring is important since several studies have shown that an altered craniocervical posture seems to influence the process of myofascial pain sensitization in the cervical muscles, which could lead to the development of the referenced pain in the masticatory muscles [ 46 , 63 , 79 , 80 ]. Moreover, a recent systematic review and meta-analysis found that there was a significant correlation with a moderate clinical effect between neck disability and jaw disability in patients with TMDs [ 40 ]. In addition, a recent review by Gil-Martínez et al [ 39 ] reported that neck disability was a strong predictor of craniofacial pain and disability in a subgroup of patients with TMDs due to muscle pain and that neck disability has a positive correlation with orofacial pain and disability, kinesiophobia, and pain catastrophizing.…”

“…Taking this into account, it seems possible that the mechanical effects from orthodontics may lead to muscular and articular adaptations on the cervical spine. Furthermore, considering that a craniocervical dysfunction may act as a contributing factor to TMDs [ 15 , 25 , 26 , 28 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ], it is reasonable to assume that the clinician should evaluate any change in the craniocervical region during orthodontic treatment, as well as any change in the TMDs complaints.…”

Disorders of the statics of the body and the temporomandibular joint

“…Additionally, there was a coexisting reduction in the range of motion of the temporomandibular joint [30][31][32].…”