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.
Highlights
Temporomandibular disorders (TMD) include a set of musculoskeletal disorders involving the temporomandibular joint (TMJ), masticatory musculature, and associated orofacial structures [1]
Neck disability TMD patients showed greater neck disability compared to the asymptomatic group Sensory-motor impairments TMD patients had lower pressure pain thresholds (PPT) values compared to the asymptomatic group
Alterations in the craniocervical position were not correlated with TMD symptomatology
Summary
Temporomandibular disorders (TMD) include a set of musculoskeletal disorders involving the temporomandibular joint (TMJ), masticatory musculature, and associated orofacial structures [1]. TMD is the leading cause of chronic nonodontogenic orofacial pain [2]. Pain in the temporomandibular region occurs in approximately 10% of the population older than 18 years and is more prevalent in young and middle-aged adults [3]. The associated signs and symptoms are more common and severe in women than in men [3,4]. Patients with TMD often experience orofacial pain, especially in the periauricular and temporal area. The pain intensity is directly related to the mandibular activity and, increases with chewing, and speech and can even hinder these actions [5]
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