Radiographic evaluation of cervical spine of subjects with temporomandibular joint internal disorder

Wagner Cesar Munhoz,José Tadeu Tesseroli De Siqueira,Amélia Pasqual Marques

doi:10.1590/s1806-83242004000400002

Wagner Cesar Munhoz, José Tadeu Tesseroli De Siqueira + Show 1 more

Open Access

https://doi.org/10.1590/s1806-83242004000400002

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Abstract

Although the etiopathophysiology of internal temporomandibular joint internal disorders (TMJ ID) is still unknown, it has been suggested that head and body posture could be related to its initial onset, development and perpetuation. The purpose of the present study was to observe the relationship between cervical spine X-ray abnormalities and TMJ ID. This investigation evaluated 30 subjects with internal TMJ disorder symptoms (test group) and 20 healthy subjects (control group). Subjects were submitted to clinical and radiographic evaluation. Clinical evaluation comprised anamnesis and stomatognathic system physical examination. Radiographic evaluation comprised analysis of lateral cervical spine X-rays by three physical therapists and tracing on the same images. The test group presented twice as much cervical spine hyperlordosis as the control group (20.7% versus 10.5%), but almost half of rectification prevalence (41.4 versus 79.0%, p = 0.03). After that, the test group was divided into three subgroups according to TMJ dysfunction severity, evaluated by Helkimo's index. These subgroups were not significantly different, but the subgroup with more severe TMD showed a tendency to cervical spine hyperlordosis prevalence. Results showed a tendency for subjects with more severe TMD to exhibit cervical spine hyperlordosis. Nevertheless, studies with a larger number of subjects suffering from severe TMD are encouraged in order to corroborate the present findings.

Highlights

Temporomandibular joint internal disorders (TMJ ID) are a specific category of TMJ dysfunction (TMD), a condition in which tissue morphology and healthy biodynamic joint elements are jeopardized, and which may lead to TMJ noises, altered mandibular movements, and pain[9]
The test group was randomly selected among patients undergoing treatment at the Orofacial Pain Clinic, Dentistry Center, Medical School Hospital, University of São Paulo, and university students
Subjects’ selection criteria followed the classification of TMJ ID symptoms of the American Academy of Orofacial Pain[9]: internal noises detectable by TMJ lateral and/or posterior poles palpation associated with disharmonic mandibular movements, or yet limitations of these movements with specific clinical characteristics

Summary

Introduction

Temporomandibular joint internal disorders (TMJ ID) are a specific category of TMJ dysfunction (TMD), a condition in which tissue morphology and healthy biodynamic joint elements are jeopardized, and which may lead to TMJ noises, altered mandibular movements, and pain[9]. Musculoskeletal pain and altered mandibular movements may compromise the TMJ system and adjacent craniocervical region[2]. Some authors believe that head[6] or body posture[8] plays a role in TMD onset and development. The reasoning would be that a chronically altered craniocervical posture could lead to mandibular postural changes through biomechanical[4] and neuromuscular mechanisms[3]. Some authors have reported postural pattern alterations in TMD subjects in comparison with healthy subjects[6,7,10], while others[1] have not found any differences between TMD and healthy subjects

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