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Tomás J, Castillo C, Villarroel G, Giner Á, Felipe N. [Effect of the forward head syndrome in the development of temporomandibular disorders]. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 10:e133. [PMID: 38390609 PMCID: PMC10880704 DOI: 10.21142/2523-2754-1004-2022-133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/02/2022] [Indexed: 02/24/2024] Open
Abstract
Bad habits, such as poor posture during the use of technological devices, poor abdominal control and oral breathing pattern can lead to a forward head position, which has important implications for the entire future of the individual, especially at the stomatognathic system. There is a strong association between temporomandibular disorders and forward head syndrome. Where the muscular component is the main affected, with the appearance of more trigger points at the level of the sternocleidomastoid muscles, upper trapezius, rectus capitis posterior and upper oblique capitis. Degenerative changes in the temporomandibular joint have been observed, but evidence is still lacking to ensure that Forward Head Syndrome is the etiological factor.
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Affiliation(s)
- Jordi Tomás
- Programa de maestría en Disfunción Craneomandibular y Dolor Orofacial, Universitat Internacional de Catalunya. Barcelona, España. , , , , Universitat Internacional de Catalunya Programa de maestría en Disfunción Craneomandibular y Dolor Orofacial Universitat Internacional de Catalunya Barcelona Spain
| | - Carolina Castillo
- Programa de maestría en Disfunción Craneomandibular y Dolor Orofacial, Universitat Internacional de Catalunya. Barcelona, España. , , , , Universitat Internacional de Catalunya Programa de maestría en Disfunción Craneomandibular y Dolor Orofacial Universitat Internacional de Catalunya Barcelona Spain
| | - Gabriela Villarroel
- Programa de maestría en Disfunción Craneomandibular y Dolor Orofacial, Universitat Internacional de Catalunya. Barcelona, España. , , , , Universitat Internacional de Catalunya Programa de maestría en Disfunción Craneomandibular y Dolor Orofacial Universitat Internacional de Catalunya Barcelona Spain
| | - Álvaro Giner
- Programa de maestría en Disfunción Craneomandibular y Dolor Orofacial, Universitat Internacional de Catalunya. Barcelona, España. , , , , Universitat Internacional de Catalunya Programa de maestría en Disfunción Craneomandibular y Dolor Orofacial Universitat Internacional de Catalunya Barcelona Spain
| | - Natalia Felipe
- Programa de maestría en Disfunción Craneomandibular y Dolor Orofacial, Universitat Internacional de Catalunya. Barcelona, España. , , , , Universitat Internacional de Catalunya Programa de maestría en Disfunción Craneomandibular y Dolor Orofacial Universitat Internacional de Catalunya Barcelona Spain
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Shen Y, Li X, Feng X, Yu L, Weng L, Zhang C, Shang Y, Lin J. Differences in the effects of orthodontic treatment on airway-craniocervical functional environment in adult and adolescent patients with skeletal class II high-angle: a retrospective pilot study. BMC Oral Health 2023; 23:605. [PMID: 37644470 PMCID: PMC10464110 DOI: 10.1186/s12903-023-03328-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023] Open
Abstract
INTRODUCTION This retrospective cohort study aimed to compare the change in upper airway and craniocervical posture after orthodontic treatment between adolescent and adult patients with Class II high-angle malocclusion. METHODS A total of 12 adolescent (mean ± standard deviation age = 13.0 ± 2.0 years) and 12 adult patients with Class II high-angle malocclusion (mean ± standard deviation age = 23.7 ± 6.4 years) were selected in this study. The lateral cephalograms and cone beam computed tomography images of adolescent and adult patients were taken before and after treatment, which can be employed to evaluate the variables of craniofacial morphology, upper airway, and craniocervical posture through paired t tests, respectively. An independent sample t test was performed to observe the differences between two groups after orthodontic intervention. For adults and adolescents, the correlation between craniofacial morphology, upper airway, and craniocervical posture was determined through Pearson correlation analysis. RESULTS In all subjects, the improvements in vertical and sagittal facial morphology after treatment were observed. Anterior and inferior movements of the hyoid bone, an increase of upper airway dimension, posterior tipping of the head and a reduction of cervical inclination in the lower and middle segments post-treatment were identified in adolescence (P < 0.05). Adults displayed anterior movements of the hyoid bone, whereas no significant difference was observed in upper airway dimension and craniocervical posture (P < 0.05). Notable differences were identified in the change of hyoid position and airway volume between two groups (P > 0.05). Mandibular plane inclination, growth pattern, occlusal plane inclination, and chin position were all significantly correlated with craniocervical posture in adolescent patients. Besides, the mandibular growth pattern and chin position in adult patients were significantly correlated with craniocervical posture (P < 0.05). CONCLUSIONS Orthodontic treatment is capable of enhancing the facial profile of patients with skeletal class II high-angle while improving their upper airway morphology and craniocervical posture, where adolescents and adults differ substantially in that the former exhibit a more favorable alteration in the airway-craniocervical functional environment.
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Affiliation(s)
- Yiyang Shen
- Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, Zhejiang, China
| | - Xin Li
- Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, Zhejiang, China
| | - Xiaoyan Feng
- Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, Zhejiang, China
| | - Lan Yu
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang, China
| | - Luxi Weng
- Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, Zhejiang, China
| | - Chenxing Zhang
- Department of Stomatology, Hangzhou Geriatric Hospital, Hangzhou, Zhejiang, China
| | - Yufeng Shang
- Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, Zhejiang, China
| | - Jun Lin
- Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, Zhejiang, China.
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Alam MK, Abutayyem H, Alzabni KMD, Almuhyi NHS, Alsabilah KAS, Alkubaydan FST, Alswairki HJ, Hajeer MY, Awawdeh MA. The Impact of Temporomandibular Disorders on Orthodontic Management: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e44243. [PMID: 37645665 PMCID: PMC10461594 DOI: 10.7759/cureus.44243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 08/31/2023] Open
Abstract
The literature on the impact of temporomandibular disorders (TMDs) on orthodontic management or vice versa lacks clarity. This study presents a review that aims to evaluate the influence of TMDs on orthodontic management and explore the association between TMDs and various aspects of orthodontic treatment. A systematic search was conducted across multiple databases to identify relevant articles documenting the correlation between TMD incidence and orthodontic treatment to achieve the objectives. The selection process followed predefined criteria, and the selected studies underwent bias assessment using the AXIS tool and Cochrane risk of bias (RoB) tool. Among the articles identified, nine studies were deemed suitable for inclusion in the review. The findings from the subsequent meta-analysis indicated a significant overall effect, suggesting that orthodontic treatment may increase the risk of developing TMD. Furthermore, the analysis revealed that patients with TMD had higher odds of experiencing orthodontic issues than those without TMD. Subgroup analysis further demonstrated that orthodontic treatment could have a negative impact on the psychological well-being of TMD patients, while its effect on TMD incidence was found to be negligible. The results highlight the need for additional research to gain a better understanding of the underlying mechanisms and develop appropriate interventions aimed at minimizing the risk of TMD in patients undergoing orthodontic treatment. Clinicians should be aware of TMD as a potential complication of orthodontic treatment and implement appropriate monitoring strategies.
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Affiliation(s)
| | - Huda Abutayyem
- Department of Clinical Sciences, Center of Medical and Bio-Allied Health Sciences Research, College of Dentistry, Ajman University, Ajman, ARE
| | | | | | | | | | | | - Mohammad Y Hajeer
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, SYR
| | - Mohammed Adel Awawdeh
- Department of Preventive Dental Science, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
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Militi A, Bonanno M, Calabrò RS. It Is Time for a Multidisciplinary Rehabilitation Approach: A Scoping Review on Stomatognathic Diseases in Neurological Disorders. J Clin Med 2023; 12:jcm12103528. [PMID: 37240633 DOI: 10.3390/jcm12103528] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Patients affected by neurological disorders can develop stomatognathic diseases (SD) related to decreased bite force and quality of mastication, bruxism, severe clicking and other temporomandibular disorders (TMD), which deeply affect patients' swallowing, masticatory and phonation functions and, therefore, their quality of life. The diagnosis is commonly based on medical history and physical examination, paying attention to the temporomandibular joint (TMJ) range of movements, jaw sounds and mandibular lateral deviation. Diagnostic tools such as computed tomography and magnetic resonance imaging are used instead in case of equivocal findings in the anamnesis and physical evaluation. However, stomatognathic and temporomandibular functional training has not been commonly adopted in hospital settings as part of formal neurorehabilitation. This review is aimed at describing the most frequent pathophysiological patterns of SD and TMD in patients affected by neurological disorders and their rehabilitative approach, giving some clinical suggestions about their conservative treatment. We have searched and reviewed evidence published in PubMed, Google Scholar, Scopus and Cochrane Library between 2010 and 2023. After a thorough screening, we have selected ten studies referring to pathophysiological patterns of SD/TMD and the conservative rehabilitative approach in neurological disorders. Given this, the current literature is still poor and unclear about the administration of these kinds of complementary and rehabilitative approaches in neurological patients suffering from SD and/or TMD.
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Affiliation(s)
- Angela Militi
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, 98125 Messina, Italy
| | - Mirjam Bonanno
- IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, SS 113, C. Da Casazza, 98123 Messina, Italy
| | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, SS 113, C. Da Casazza, 98123 Messina, Italy
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Minervini G, Franco R, Marrapodi MM, Crimi S, Badnjević A, Cervino G, Bianchi A, Cicciù M. Correlation between Temporomandibular Disorders (TMD) and Posture Evaluated trough the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): A Systematic Review with Meta-Analysis. J Clin Med 2023; 12:jcm12072652. [PMID: 37048735 PMCID: PMC10095000 DOI: 10.3390/jcm12072652] [Citation(s) in RCA: 54] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/27/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023] Open
Abstract
Background: Temporomandibular disorders (TMDs) are a series of disorders that affect the muscles and joint. Symptoms include joint pain, muscle pain, and limitation of mouth opening. One of several multifactorial diseases, temporomandibular dysfunction has mostly been linked to five etiological factors: occlusion, trauma, severe pain stimuli, parafunctional activities, and psychological elements, including stress, anxiety, and depression. The position of the human body as it is displayed in space is referred to as posture. Several nerve pathways regulate posture, and through ligaments, TMD and posture affect each other. The purpose of this study is to evaluate the possible correlation between posture and TMD through a meta-analysis of the literature; Methods: A literature search was performed on PubMed, Lilacs, and Web of science, and articles published from 2000 to 31 December 2022 were considered, according to the keywords entered. The term “temporomandibular disorders” has been combined with “posture”, using the Boolean connector AND; Results: At the end of the research, 896 studies were identified from the search conducted on the 3 engines. Only three were chosen to draw up the present systematic study summarizing the article’s main findings. The meta-analysis showed through forest plot analysis a correlation between posture and TMD Conclusions: This literature meta-analysis showed a correlation between posture and TMD. Nerve pathways probably regulate both body posture and mandibular posture. Further clinical studies will be needed to confirm this hypothesis and to indicate the main conclusions or interpretations.
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Affiliation(s)
- Giuseppe Minervini
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy
| | - Rocco Franco
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00100 Rome, Italy
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy
| | - Salvatore Crimi
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Almir Badnjević
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, 71000 Sarajevo, Bosnia and Herzegovina
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, School of Dentistry, University of Messina, Via Consolare Valeria, 1, 98125 Messina, Italy
| | - Alberto Bianchi
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Marco Cicciù
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
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Do Temporomandibular Disorder Patients with Joint Pain Exhibit Forward Head Posture? A Cephalometric Study. Pain Res Manag 2023; 2023:7363412. [PMID: 36776487 PMCID: PMC9911253 DOI: 10.1155/2023/7363412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/14/2022] [Accepted: 11/25/2022] [Indexed: 02/05/2023]
Abstract
Purpose To evaluate head and cervical posture in individuals with or without temporomandibular disorders (TMDs) and to assess the correlations between pain, severity of symptoms, and posture. Methods A total of 384 patients (129 males and 255 females) was included. The Fonseca Anamnestic Index (FAI) was used to assess the severity and prevalence of TMD and the presence of temporomandibular joint (TMJ) pain. Patients were divided into three groups: the TMD-free group, TMD without TMJ pain group, and TMD with TMJ pain group. Subsequently, the patients with TMJ pain were further divided into mild TMD and moderate/severe TMD groups. Nine parameters were traced on cephalograms to characterize the head and cervical posture. Results TMD patients with TMJ pain showed increased forward head posture (FHP) than patients without TMJ pain and TMD-free subjects. No significant difference was observed between the TMD patients without TMJ pain and TMD-free subjects. In the TMD patients with the TMJ pain group, the moderate/severe TMD patients demonstrated increased FHP compared to mild TMD patients. TMD patients with joint pain had greater CVT/RL (B = 3.099), OPT/RL (B = 2.117), and NSL/C2' (B = 4.646) than the patients without joint pain after adjusting for confounding variables (P < 0.05). Conclusion TMD patients with TMJ pain showed increased FHP compared to other groups, and FHP became more significant as TMD severity increased in male patients, indicating the FHP might play an important role in the development of TMJ pain. In the clinical assessment of TMD, the patients' abnormal head and cervical posture might be considered.
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Cephalometric assessment regarding craniocervical posture in orthodontic patients. Sci Rep 2022; 12:21729. [PMID: 36526718 PMCID: PMC9758121 DOI: 10.1038/s41598-022-26243-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
A major factor that contributes to dental malocclusions is represented by the positioning of the mandible. Considering the existing interconnections between the craniocervical and craniomandibular systems it is interesting to assess how changes in one system can influence the other, thus establishing a pattern in terms of certain cephalometric landmarks that orthodontists could consider when diagnosing and evaluating an orthodontic case. Therefore, the aim of this study was to investigate the connections between cervical posture, head position, hyoid bone position in orthodontic patients with different skeletal patterns. 45 lateral cephalometric radiographs were analyzed. Skeletal class and vertical growth were the main elements that were considered when classifying patients. Craniofacial and Cervical landmarks were determined on the cephalograms, from which lines and angles resulted which were considered relevant in our study. Correlations between cephalometric variables of the patients were determined. there were some statistically significant changes identified concerning craniocervical posture and hyoid bone position between the patients in the following parameters: H-Rgn, OPT/HOR, CVT/HOR, OPT/SN, CVT/SN, H-SN. The results obtained allowed us to conclude that there were some differences at the skeletal level of the sample of patients studied. The findings are indicating that there is a close relationship between, mandible position, cervical- and head posture and the hyoid bone. The information obtained in this study could help to better understand the development of malocclusions, and to improve the orthodontic diagnostic and treatment plan.
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Zhu R, Zheng YH, Zhang ZH, Fan PD, Wang J, Xiong X. Development of a new category system for the profile morphology of temporomandibular disorders patients based on cephalograms using cluster analysis. Front Public Health 2022; 10:1045815. [PMID: 36466455 PMCID: PMC9713943 DOI: 10.3389/fpubh.2022.1045815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/04/2022] [Indexed: 11/18/2022] Open
Abstract
Objective This study aims to develop a new category scheme for the profile morphology of temporomandibular disorders (TMDs) based on lateral cephalometric morphology. Methods Five hundred and one adult patients (91 males and 410 females) with TMD were enrolled in this study. Cluster tendency analysis, principal component analysis and cluster analysis were performed using 36 lateral cephalometric measurements. Classification and regression tree (CART) algorithm was used to construct a binary decision tree based on the clustering results. Results Twelve principal components were discovered in the TMD patients and were responsible for 91.2% of the variability. Cluster tendency of cephalometric data from TMD patients were confirmed and three subgroups were revealed by cluster analysis: (a) cluster 1: skeletal class I malocclusion; (b) cluster 2: skeletal class I malocclusion with increased facial height; (c) cluster 3: skeletal class II malocclusion with clockwise rotation of the mandible. Besides, CART model was built and the eight key morphological indicators from the decision tree model were convenient for clinical application, with the prediction accuracy up to 85.4%. Conclusion Our study proposed a novel category system for the profile morphology of TMDs with three subgroups according to the cephalometric morphology, which may supplement the morphological understanding of TMD and benefit the management of the categorical treatment of TMD.
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Affiliation(s)
- Rui Zhu
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Yun-Hao Zheng
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Zi-Han Zhang
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Pei-Di Fan
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Jun Wang
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Xin Xiong
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China,Department of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Sichuan, China,*Correspondence: Xin Xiong
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Crăciun MD, Geman O, Leuciuc FV, Holubiac IŞ, Gheorghiţă D, Filip F. Effectiveness of Physiotherapy in the Treatment of Temporomandibular Joint Dysfunction and the Relationship with Cervical Spine. Biomedicines 2022; 10:biomedicines10112962. [PMID: 36428529 PMCID: PMC9687864 DOI: 10.3390/biomedicines10112962] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022] Open
Abstract
Temporomandibular dysfunctions are a heterogeneous group of conditions involving the temporomandibular joints (TMJs) and periarticular musculoskeletal structures. This study aimed to evaluate the effectiveness of a physiotherapy program for TMJ dysfunctions and the relationship with cervical spine. The study design was a non-randomized clinical trial with two parallel treatment groups: 33 subjects in the experimental group that underwent conservative drug treatment and physiotherapy treatment, and 31 subjects in the control group that underwent only conservative drug treatment. The participants were examined at baseline and re-examined after 3 months. In this study there was a higher incidence of female subjects. After 3 months of treatment of the TMJs and cervical spine, pain decreased in both groups (p = 0001). Muscle testing at the cervical spine and temporomandibular level showed a decrease in pain and muscles spasms. The average percentage values of the Neck Disability Index (NDI) and the Jaw Functional Limitation Scale 8 (JFLS 8) decreased significantly in both groups, but especially in the experimental group (p = 0.001). Physiotherapy treatments could maintain the functional state at the temporomandibular and cervical levels, thus contributing to increasing the quality of daily life.
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Affiliation(s)
- Maria Daniela Crăciun
- Interdisciplinary Research Centre in Motricity Sciences and Human Health, Ştefan cel Mare University of Suceava, 720229 Suceava, Romania
- Correspondence: (M.D.C.); (O.G.)
| | - Oana Geman
- Neuroaesthetics Laboratory, Ştefan cel Mare University of Suceava, 720229 Suceava, Romania
- Correspondence: (M.D.C.); (O.G.)
| | - Florin Valentin Leuciuc
- Interdisciplinary Research Centre in Motricity Sciences and Human Health, Ştefan cel Mare University of Suceava, 720229 Suceava, Romania
| | - Iulian Ştefan Holubiac
- Interdisciplinary Research Centre in Motricity Sciences and Human Health, Ştefan cel Mare University of Suceava, 720229 Suceava, Romania
| | - Daniela Gheorghiţă
- Dentist’s Office Omnis Dental, Ştefan cel Mare University of Suceava, 720229 Suceava, Romania
| | - Florin Filip
- County Hospital of Suceava, Ştefan cel Mare University of Suceava, 720229 Suceava, Romania
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Neural Basis of Etiopathogenesis and Treatment of Cervicogenic Orofacial Pain. Medicina (B Aires) 2022; 58:medicina58101324. [PMID: 36295485 PMCID: PMC9611820 DOI: 10.3390/medicina58101324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/15/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background and Objectives: The aim of this narrative review was to analyze the neuroanatomical and neurophysiological basis of cervicogenic pain in cervico-cranial pain syndromes, focusing particularly on cervico-orofacial syndromes as a background for the proper diagnosis and non-surgical treatment. Relevant literature on the topic from past 120 years has been surveyed. (2) Material and Methods: We surveyed all original papers, reviews, or short communications published in the English, Spanish, Czech or Slovak languages from 1900 to 2020 in major journals. (3) Results: The cervicogenic headache originates from the spinal trigeminal nucleus where axons from the C1–C3 cervical spinal nerves and three branches of the trigeminal nerve converge (trigeminocervical convergence) at the interneurons that mediate cranio-cervical nociceptive interactions. The role of the temporomandibular joint in the broad clinical picture is also important. Despite abundant available experimental and clinical data, cervicogenic orofacial pain may be challenging to diagnose and treat. Crucial non-surgical therapeutic approach is the orthopedic manual therapy focused on correction of body posture, proper alignment of cervical vertebra and restoration of normal function of temporomandibular joint and occlusion. In addition, two novel concepts for the functional synthesis of cervico-cranial interactions are the tricentric concept of mouth sensorimotor control and the concept of a cervicogenic origin of bruxism. (4) Conclusions: Understanding the basis of neuroanatomical and neurophysiological neuromuscular relations enables an effective therapeutic approach based principally on orthopedic manual and dental occlusal treatment.
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