Assessment of cervical spine postural disorders in patients with temporomandibular dysfunction: a radiographic evaluation

This study aimed to assess the impact of abnormal head and neck posture on development of temporomandibular disorders (TMD) and to evaluate the possible correlation between cervical spine postural disorders and TMD by measuring craniocervical angles and distances in cervical spine radiographs of individuals with and without symptoms of temporomandibular joint dysfunction. Forty-six subjects aged 20-50 years were selected from the outpatient department of M.S. Ramaiah Dental College and divided into TMD and control groups with 23 subjects per group. The patients were subjected to clinical and radiographic evaluations. TMD diagnosis was based on clinical criteria in the Research Diagnostic Criteria for TMD (RDC/TMD). Radiographic evaluation comprised intraobserver and interobserver analyses of lateral cervical spine radiographs with measurements of three angles and two distances in the craniocervical region. Diagnosis of myofascial pain without limited mouth opening (n = 12) was the most frequent TMD diagnosis according to RDC/TMD. Radiographic evaluation showed that only atlas plane angle (APA) (p = 0.002) and anterior translation distance (ATD; Tz C-2-C-7) (p < 0.001) showed significant differences between the TMD group (APA: 20.96 +/- A 7.94A degrees; ATD: 11.04 +/- A 5.270 mm) and control group (APA: 28.17 +/- A 10.395A degrees, ATD: 5.70 +/- A 3.535 mm). Significant correlations were observed for the parameters between the observers (p < 0.05). The present results suggest that head and body posture could be related to the initial onset, development, and perpetuation of TMD and that TMD patients have a tendency to exhibit cervical spine hyperlordosis.