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Opris H, Baciut M, Bran S, Onisor F, Almasan O, Manea A, Tamas T, Stoia S, Gabriel A, Baciut G, Crisan B, Hedesiu M, Crisan L, Barbur I, Opris D, Dinu C. Lateral Cephalometric Analytical Uses for Temporomandibular Joint Disorders: The Importance of Cervical Posture and Hyoid Position. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191711077. [PMID: 36078792 PMCID: PMC9518302 DOI: 10.3390/ijerph191711077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/27/2022] [Accepted: 08/31/2022] [Indexed: 06/01/2023]
Abstract
The temporomandibular joint disorder (TMD) is a syndrome that affects the masticatory muscles and temporomandibular joint (TMJ). Its pathophysiology is not yet fully known. Cephalometric analysis is used for routine evaluation regarding orthodontic treatment and other purposes. The aim of this study was to assess if using cephalometric analysis and TMJ conservative therapy to evaluate the hyoid bone position and the cervical posture reduced symptoms in adults with TMDs compared to no intervention. The authors conducted a systematic review of the literature (PubMed, Cochrane, Web of Science, Scopus, and Embase) for clinical studies of TMDs with conservative treatment and lateral cephalometric analysis of the hyoid and cervical posture. To assess the risk of bias for non-randomized clinical trials ROBINS-I tool was used. Out of 137 studies found, 6 remained to be included. Most of them found a link between TMD and lateral cephalometric analysis, but there was a high risk of bias. This review found a possible link between TMDs, the neck and cervical posture. There is a benefit reported regarding the use of the lateral cephalometry as a treatment, but more extensive prospective randomized clinical trials are necessary to be able to draw definitive conclusions.
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Affiliation(s)
- Horia Opris
- Department of Maxillofacial Surgery and Implantology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Mihaela Baciut
- Department of Maxillofacial Surgery and Implantology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Simion Bran
- Department of Maxillofacial Surgery and Implantology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Florin Onisor
- Department of Maxillofacial Surgery and Implantology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Oana Almasan
- Department of Prosthetic Dentistry, Faculty of Dentistry, Iuliu Haţieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400012 Cluj-Napoca, Romania
| | - Avram Manea
- Department of Maxillofacial Surgery and Implantology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Tiberiu Tamas
- Department of Maxillofacial Surgery and Implantology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Sebastian Stoia
- Department of Maxillofacial Surgery and Implantology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Armencea Gabriel
- Department of Maxillofacial Surgery and Implantology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Grigore Baciut
- Department of Maxillofacial Surgery and Implantology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Bogdan Crisan
- Department of Maxillofacial Surgery and Implantology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Mihaela Hedesiu
- Department of Radiology, Faculty of Dentistry, Iuliu Haţieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400012 Cluj-Napoca, Romania
| | - Liana Crisan
- Department of Maxillofacial Surgery and Implantology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Ioan Barbur
- Department of Maxillofacial Surgery and Implantology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Daiana Opris
- Department of Maxillofacial Surgery and Implantology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Cristian Dinu
- Department of Maxillofacial Surgery and Implantology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
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Craniovertebral and Craniomandibular Changes in Patients with Temporomandibular Joint Disorders after Physiotherapy Combined with Occlusal Splint Therapy: A Prospective Case Control Study. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58050684. [PMID: 35630101 PMCID: PMC9146339 DOI: 10.3390/medicina58050684] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/17/2022] [Accepted: 05/20/2022] [Indexed: 01/03/2023]
Abstract
Background and Objectives: The aim of the study was to assess the craniovertebral and craniomandibular changes in patients diagnosed with temporomandibular joint disorders (TMD) after physiotherapy combined with occlusal splint therapy. Materials and Methods: There were forty patients (32 females, 80%), diagnosed with TMD, included into the study group. After the initial series of physiotherapy, patients received maxillary occlusal splints to be worn day and night. Participants continued physiotherapy simultaneously with occlusal splint therapy for 6 months. Lateral cephalograms taken in natural head position before and after the end of the therapy were used for measurements. The control group consisted of 15 healthy participants (12 females, 80%), who had taken lateral cephalograms twice, and did not receive any type of occlusal treatment nor physiotherapy in the meantime. Results: Occlusal splint therapy and physiotherapy combined together significantly affected: the vertical position of the mandible (significant increase, p < 0.0001), the sagittal position of mandible (significant decrease, p = 0.0065), as well as the width of the functional space between C1 and C2 (significant decrease, p = 0.0042). Moreover, the cervical lordosis was restored after the end of the treatment (p < 0.0001). Conclusions: Cooperation of physiotherapists with dental practitioners is necessary in the treatment of patients with TMD, including temporomandibular joint osteoarthritis.
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Liu Y, Wang S, Wang C, Liu C. Relationships of vertical facial pattern, natural head position and craniocervical posture in young Chinese children. Cranio 2017; 36:311-317. [PMID: 28669326 DOI: 10.1080/08869634.2017.1345461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To investigate relationships of vertical facial patterns, natural head position (NHP), and craniocervical posture in young Chinese children with skeletal Class I relationship. METHODS Ninety-four patients with skeletal Class I relationship were classified into low, average, and high angle groups according to their mandibular plane angle (NSL/ML). Cephalometric radiographs in NHP were taken. Variables representing vertical and sagittal craniofacial morphology, head posture, and craniocervical posture were measured and compared. RESULTS Inclinations of the mandible to the true vertical and cervical column were smallest in the high angle group and largest in the low angle group. Other variables representing head posture and craniocervical posture were largest in the high angle group, smallest in the low angle group. Inclinations of ramus to cervical column were largest in the high angle group and smallest in the low angle group. DISCUSSION Subjects with large NSL/ML angles showed extended head and craniocervical posture, while subjects with small NSL/ML angles exhibited flexed head and craniocervical posture.
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Affiliation(s)
- Ying Liu
- a Department of Orthodontics , School of Stomatology, JiLin University , Changchun , China
| | - Shuo Wang
- b Key Laboratory of Oral Medicine , Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University , Guangzhou , China
| | - Chunhui Wang
- b Key Laboratory of Oral Medicine , Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University , Guangzhou , China
| | - Chang Liu
- b Key Laboratory of Oral Medicine , Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University , Guangzhou , China
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Ando E, Shigeta Y, Hirabayashi R, Ikawa T, Hirai S, Katsumura S, Ogawa T. Cervical curvature variations in patients with infraocclusion. J Oral Rehabil 2014; 41:601-7. [DOI: 10.1111/joor.12187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2014] [Indexed: 11/30/2022]
Affiliation(s)
- E. Ando
- Department of Fixed Prosthodontic Dentistry; School of Dental Medicine; Tsurumi University; Yokohama Japan
| | - Y. Shigeta
- Department of Fixed Prosthodontic Dentistry; School of Dental Medicine; Tsurumi University; Yokohama Japan
| | - R. Hirabayashi
- Department of Fixed Prosthodontic Dentistry; School of Dental Medicine; Tsurumi University; Yokohama Japan
| | - T. Ikawa
- Department of Fixed Prosthodontic Dentistry; School of Dental Medicine; Tsurumi University; Yokohama Japan
| | - S. Hirai
- Department of Fixed Prosthodontic Dentistry; School of Dental Medicine; Tsurumi University; Yokohama Japan
| | - S. Katsumura
- Department of Forensic Medicine and Dentistry; School of Dental Medicine; Tsurumi University; Yokohama Japan
| | - T. Ogawa
- Department of Fixed Prosthodontic Dentistry; School of Dental Medicine; Tsurumi University; Yokohama Japan
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LA TOUCHE R, FERNÁNDEZ-DE-LAS-PEÑAS C, FERNÁNDEZ-CARNERO J, ESCALANTE K, ANGULO-DÍAZ-PARREÑO S, PARIS-ALEMANY A, CLELAND JA. The effects of manual therapy and exercise directed at the cervical spine on pain and pressure pain sensitivity in patients with myofascial temporomandibular disorders. J Oral Rehabil 2009; 36:644-52. [DOI: 10.1111/j.1365-2842.2009.01980.x] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Mansilla-Ferragut P, Fernández-de-Las Peñas C, Alburquerque-Sendín F, Cleland JA, Boscá-Gandía JJ. Immediate effects of atlanto-occipital joint manipulation on active mouth opening and pressure pain sensitivity in women with mechanical neck pain. J Manipulative Physiol Ther 2009; 32:101-6. [PMID: 19243721 DOI: 10.1016/j.jmpt.2008.12.003] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2008] [Revised: 10/12/2008] [Accepted: 10/17/2008] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the effects of a spinal thrust manipulation directed to the upper cervical segments (atlanto-occipital joint) on active mouth opening and pressure pain sensitivity in a trigeminal nerve innervated region (sphenoid bone) in women with mechanical neck pain. METHODS Thirty-seven women, ages 21 to 50 years old (mean age, 35 +/- 8 years) with mechanical neck pain were recruited for this study. Participants were randomly assigned into 1 of 2 groups as follows: an experimental group that received a spinal manipulation of the atlanto-occipital joint and a control group that received a manual contact placebo intervention. Outcomes collected were assessed pretreatment and 5 minutes posttreatment by an assessor blinded to the treatment allocation and included active mouth opening and pressure pain thresholds (PPTs) over both sides of the sphenoid bone. A 2-way repeated measures analysis of variance (ANOVA) with time (pre-post) as the within subjects variable and group (control, experimental) as the between subjects variable was used to examine the effects of the intervention. The hypothesis of interest was group-time interaction. RESULTS The ANOVA showed a significant effect for time (F = 23.1; P < .001) and an interaction between group and time (F = 37.7; P < .001) for active mouth opening as follows: the experimental group showed a greater improvement when compared to the control group. A large positive within-group effect size (d > 1.5) for the experimental group, whereas a negative medium within-group effect size (d = -0.5) for the control group were identified. The ANOVA showed a significant interaction between group and time (F = 14.4; P < .001) for PPT levels at the sphenoid bone as follows: the experimental group showed a greater improvement when compared to the control group. A medium positive within-group effect size (d = -0.5) for the experimental group, whereas a negative medium within-group effect size (d = -0.5) for the control group was found. CONCLUSIONS Our findings suggest that the application of an atlantoaxial joint thrust manipulation resulted in an increase in active mouth opening and PPT over a trigeminal nerve distribution area (sphenoid bone) in women with mechanical neck pain.
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Armijo-Olivo S, Magee DJ. Electromyographic activity of the masticatory and cervical muscles during resisted jaw opening movement. J Oral Rehabil 2007; 34:184-94. [PMID: 17302946 DOI: 10.1111/j.1365-2842.2006.01664.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
One of the relaxation techniques that have been used by physical therapists when treating patients with temporomandibular disorders, is the agonist contract-antagonist relax technique (AC). When the AC technique is applied, a submaximal resistance to the jaw opening movement is necessary to cause relaxation of the masticatory muscles. No information about the effect of this technique on masticatory or cervical muscles has been found in the literature. Thus, the aim of this study was to evaluate the electromyographic activity of the masseter and anterior temporalis and the upper trapezius and splenius capitis during resisted jaw opening movement. A convenience sample of 30 students was used. Electromyography activity of the superficial masseter, anterior temporalis, upper trapezius and splenius capitis was registered before, during and after the application of this resistive movement to jaw opening. A two-way anova with repeated measures analysis was used to analyse data. The level of significance was at alpha = 0.05. The EMG activity of both the masticatory muscles and the cervical muscles increased during and after the application of resisted jaw opening (P < 0.05). Based on the results obtained from this study, the behaviour of all muscles analysed (masseter, anterior temporalis, splenius capitis and upper trapezius) was similar. All muscles increased their activity when the resistance to the jaw opening movement was applied. Complex muscular interactions of the supra- and infrahyoid muscles (jaw openers), masticatory muscles, and cervical muscles may exist to stabilize the craniomandibular system during resisted jaw opening.
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Affiliation(s)
- S Armijo-Olivo
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
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Catanzariti JF, Debuse T, Duquesnoy B. Chronic neck pain and masticatory dysfunction. Joint Bone Spine 2004; 72:515-9. [PMID: 16226475 DOI: 10.1016/j.jbspin.2004.10.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2004] [Accepted: 10/18/2004] [Indexed: 11/28/2022]
Abstract
Chronic nonspecific neck pain is a common problem in rheumatology and may resist conventional treatment. Pathophysiological links exist between the cervical spine and masticatory system. Occlusal disorders may cause neck pain and may respond to dental treatment. The estimated prevalence of occlusal disorders is about 45%, with half the cases being due to functional factors. Minor repeated masticatory dysfunction (MD) with craniocervical asymmetry is the most common clinical picture. The pain is usually located in the suboccipital region and refractory to conventional treatment. The time pattern may be suggestive, with nocturnal arousals or triggering by temporomandibular movements. MD should be strongly suspected in patients with at least two of the following: history of treated or untreated MD, unilateral temporomandibular joint pain and clicking, lateral deviation during mouth opening, and limitation of mouth opening (less than three fingerbreadths). Rheumatologists should consider MD among causes of neck pain, most notably in patients with abnormal craniocervical posture, signs linking the neck pain to mastication, and clinical manifestations of MD. Evidence suggesting that MD may cause neck pain has been published. However, studies are needed to determine whether treatment of MD can relieve neck pain.
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Affiliation(s)
- Jean-François Catanzariti
- Rheumatology Department, Salengro Teaching Hospital, André Verhaeghe Center, Lille Teaching Hospitals, 59037 Lille cedex, France
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Zúñiga C, Miralles R, Carvajal R, Ravera MJ, Contreras P, Cavada G. Comparative Study Between Children with and without Cleft Lip and Cleft Palate, Part 1: Cephalometric Analysis. Cleft Palate Craniofac J 2000. [DOI: 10.1597/1545-1569(2000)037<0281:csbcwa>2.3.co;2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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