The relationship between temporomandibular dysfunction and head and cervical posture

Abstract

Objective:This study aimed to evaluate the possibility of any correlation between disc displacement and parameters used for evaluation of skull positioning in relation to the cervical spine: craniocervical angle, suboccipital space between C0-C1, cervical curvature and position of the hyoid bone in individuals with and without symptoms of temporomandibular dysfunction.Material and Methods:The patients were evaluated following the guidelines set forth by RDC/TMD. Evaluation was performed by magnetic resonance imaging for establishment of disc positioning in the temporomandibular joints (TMJs) of 30 volunteer patients without temporomandibular dysfunction symptoms and 30 patients with symptoms. Evaluation of skull positioning in relation to the cervical spine was performed on lateral cephalograms achieved with the individual in natural head position. Data were submitted to statistical analysis by Fisher's exact test at 5% significance level. To measure the degree of reproducibility/agreements between surveys, the kappa (K) statistics was used.Results:Significant differences were observed between C0-C1 measurement for both symptomatic (p=0.04) and asymptomatic (p=0.02). No statistical differences were observed regarding craniocervical angle, C1-C2 and hyoid bone position in relation to the TMJs with and without disc displacement. Although statistically significant difference was found in the C0-C1 space, no association between these and internal temporomandibular joint disorder can be considered.Conclusion:Based on the results observed in this study, no direct relationship could be determined between the presence of disc displacement and the variables assessed.

Cervical spine dysfunction signs and symptoms in individuals with temporomandibular disorder

“…This result reinforces the data of recent studies (19,20) , which did not find postural Note: G1 = temporomandibular disorder group; G2 = group without temporomandibular disorder Mann-Whitney test (p<0.05) Note: G1 = temporomandibular disorder group; G2 = group without temporomandibular disorder; SD = standard deviation; CPL/Hor = forward head posture angle; EVT/CVT = cervical lordosis angle; CVA = craniovertebral angle, referent to flexion/extension position of the head differences between patients with TMD and asymptomatic individuals. Such studies also used the cephalometric analysis and RDC/TMD to the TMD diagnostic.…”

“…Flexion/extension head position in relation to superior cervical spine was measured through Rocabado craniovertebral angle, recently referred on literature (19)(20)(21) . This angle is formed by McGregor Plan (plan which tangencies the base of the occipital bone till it reaches the posterior nasal spine) and the Odontoid Plan (which comes from the top of the odontoid process of C2 till a most anterior and inferior point of the body of C2).…”

Influence of the presence of Temporomandibular Disorders on postural balance in the elderly

“…Most studies have centered mainly on the relationship of the position of the head and the cervical spine by means of angular measures in patients with TMD (6,9,(22)(23)(24) , and did not objectively quantify parameters related to mechanisms of postural balance, such as COP measures and velocity, which are regarded today as the two most accurate and reliable variables to quantify balance deficits (11,25) . These measures were addressed in the present study and support the reliability of the results observed by the authors for the population under study.…”

The role of the clinical examination in management of temporo-mandibular and cervical disorders

“…By palpating the cervical zygapophyseal joints examiners can differentiate between subjects with cervical pain and healthy subjects with 82 % sensitivity and a 79 % specificity [19][20][21][22][23][24][25] .…”

“…However, a host of studies have failed to substantiate a supposed correlation between head posture and internal derangements of the temporo-mandibular joint nor have they found any significant differences in this regard between groups of patients with TMD and cranio-cervical disorders as compared to control groups 2,12,22,24,26 .…”