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Cervical spine dysfunction signs and symptoms in individuals with temporomandibular disorder
Weber, Priscila;Corrêa, Eliane Castilhos Rodrigues;Ferreira, Fabiana dos Santos;Soares, Juliana Corrêa;Bolzan, Geovana de Paula;Silva, Ana Maria Toniolo da;
Jornal da Sociedade Brasileira de Fonoaudiologia , 2012, DOI: 10.1590/S2179-64912012000200008
Abstract: purpose: to study the frequency of cervical spine dysfunction (ccd) signs and symptoms in subjects with and without temporomandibular disorder (tmd) and to assess the craniocervical posture influence on tmd and ccd coexistence. methods: participants were 71 women (19 to 35 years), assessed about tmd presence; 34 constituted the tmd group (g1) and 37 comprised the group without tmd (g2). the ccd was evaluated through the craniocervical dysfunction index and the cervical mobility index. subjects were also questioned about cervical pain. craniocervical posture was assessed by cephalometric analysis. results: there was no difference in the craniocervical posture between groups. g2 presented more mild ccd frequency and less moderate and severe ccd frequency (p=0.01). g1 presented higher percentage of pain during movements (p=0.03) and pain during cervical muscles palpation (p=0.01) compared to g2. most of the tmd patients (88.24%) related cervical pain with significant difference when compared to g2 (p=0.00). conclusion: craniocervical posture assessment showed no difference between groups, suggesting that postural alterations could be more related to the ccd. presence of tmd resulted in higher frequency of cervical pain symptom. thus the coexistence of ccd and tmd signs and symptoms appear to be more related to the common innervations of the trigeminocervical complex and hyperalgesia of the tmd patients than to craniocervical posture deviations.
The relationship between temporomandibular dysfunction and head and cervical posture
Matheus, Ricardo Alves;Ramos-Perez, Flávia Maria de Moraes;Menezes, Alynne Vieira;Ambrosano, Gláucia Maria Bovi;Haiter-Neto, Francisco;Bóscolo, Frab Norberto;Almeida, Solange Maria de;
Journal of Applied Oral Science , 2009, DOI: 10.1590/S1678-77572009000300014
Abstract: objective: this study aimed to evaluate the possibility of any correlation between disc displacement and parameters used for evaluation of skull positioning in relation to the cervical spine: craniocervical angle, suboccipital space between c0-c1, cervical curvature and position of the hyoid bone in individuals with and without symptoms of temporomandibular dysfunction. material and methods: the patients were evaluated following the guidelines set forth by rdc/tmd. evaluation was performed by magnetic resonance imaging for establishment of disc positioning in the temporomandibular joints (tmjs) of 30 volunteer patients without temporomandibular dysfunction symptoms and 30 patients with symptoms. evaluation of skull positioning in relation to the cervical spine was performed on lateral cephalograms achieved with the individual in natural head position. data were submitted to statistical analysis by fisher's exact test at 5% significance level. to measure the degree of reproducibility/agreements between surveys, the kappa (k) statistics was used. results: significant differences were observed between c0-c1 measurement for both symptomatic (p=0.04) and asymptomatic (p=0.02). no statistical differences were observed regarding craniocervical angle, c1-c2 and hyoid bone position in relation to the tmjs with and without disc displacement. although statistically significant difference was found in the c0-c1 space, no association between these and internal temporomandibular joint disorder can be considered. conclusions: based on the results observed in this study, no direct relationship could be determined between the presence of disc displacement and the variables assessed.
Radiographic evaluation of cervical spine of subjects with temporomandibular joint internal disorder
Munhoz, Wagner Cesar;Marques, Amélia Pasqual;Siqueira, José Tadeu Tesseroli de;
Brazilian Oral Research , 2004, DOI: 10.1590/S1806-83242004000400002
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 im ages. 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.
Cervical spine signs and symptoms: perpetuating rather than predisposing factors for temporomandibular disorders in women
Bevilaqua-Grossi, Débora;Chaves, Thaís Cristina;Oliveira, Anamaria Siriani de;
Journal of Applied Oral Science , 2007, DOI: 10.1590/S1678-77572007000400004
Abstract: aim: the purpose of this study was to assess in a sample of female community cases the relationship between the increase of percentage of cervical signs and symptoms and the severity of temporomandibular disorders (tmd) and vice-versa. material and methods: one hundred women (aged 18-26 years) clinically diagnosed with tmd signs and symptoms and cervical spine disorders were randomly selected from a sample of college students. results: 43% of the volunteers demonstrated the same severity for tmd and cervical spine disorders (csd). the increase in tmd signs and symptoms was accompanied by increase in csd severity, except for pain during palpation of posterior temporal muscle, more frequently observed in the severe csd group. however, increase in pain during cervical extension, sounds during cervical lateral flexion, and tenderness to palpation of upper fibers of trapezius and suboccipital muscles were observed in association with the progression of tmd severity. conclusion: the increase in cervical symptomatology seems to accompany tmd severity; nonetheless, the inverse was not verified. such results suggest that cervical spine signs and symptoms could be better recognized as perpetuating rather than predisposing factors for tmd.
Cervical Spine Motion During Extrication: A Pilot Study  [cached]
Shafer, Jeffrey S,Naunheim, Rosanne S
Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health , 2009,
Abstract: Spinal immobilization is one of the most commonly performed pre-hospital procedures. Little research has been done on the movement of the neck during immobilization and extrication. In this study we used a sophisticated infrared six-camera motion-capture system (Motion Analysis Corporation, Santa Rosa, CA), to study the motion of the neck and head during extrication. A mock automobile was constructed to scale, and volunteer patients, with infrared markers on bony prominences, were extricated by experienced paramedics. We found in this pilot study that allowing an individual to exit the car under his own volition with cervical collar in place may result in the least amount of motion of the cervical spine. Further research should be conducted to verify these findings. In addition, this system could be utilized to study a variety of methods of extrication from automobile accidents. [WestJEM. 2009;10:74-78.]
Reactive arthritis of the temporomandibular joints and cervical spine in a child
Bita Arabshahi, Kevin M Baskin, Randy Q Cron
Pediatric Rheumatology , 2007, DOI: 10.1186/1546-0096-5-4
Abstract: A 6-year-old Native American boy hospitalized for treatment of lymphadenitis and aseptic meningitis had an incidental brain magnetic resonance imaging (MRI) finding of effusions in the TMJs, as well as the atlanto-occipital and C1–C2 articulations. Repeat TMJ and cervical spine MRI four weeks later showed resolution of effusions. Reactive TMJ arthritis has been previously reported in adults but not in children.This report represents the first pediatric case of reactive arthritis isolated to the cervical spine and TMJs. Arthritis of the TMJ should be considered in the differential diagnosis of children with reactive arthritides.A 6-year-old previously healthy Native American boy presented to the Emergency Department with a one-week history of right-sided anterior neck pain, progressing to swelling and fever and unresponsive to amoxicillin. Rapid group A Streptococcal antigen testing prior to initiation of amoxicillin was negative. He was admitted to the hospital with a diagnosis of lymphadenitis and started on intravenous (IV) clindamycin. He continued to be febrile up to 40.6°C despite antibiotic therapy, and received ibuprofen and acetominophen for management of fever. His physical examination was notable for trismus, right-sided neck swelling and erythema, and anterior right-sided neck pain limiting neck extension, but not flexion. On the third hospital day he developed a frontal headache and became increasingly somnolent and difficult to arouse. Head Computed Tomography (CT) was normal. Lumbar puncture revealed an elevated cerebrospinal fluid (CSF) protein of 80 mg/dL, a normal glucose level, red blood cells of 3 per cubic millimeter (mm3), and elevated white blood cells of 29 per mm3 (21% neutrophils, 52% lymphocytes, 27% monocytes). His CSF and blood cultures were negative and he had normal Ebstein-Barr virus and Bartonella antibody titers. He was started on IV cefotaxime for broader antibiotic coverage but was presumed to have aseptic meningitis. His fever and
Torticollis and Temporomandibular Joint Dysfunction  [cached]
Hasan TOKTA?,Deniz EVC?K,?lknur Y???T,Vural KAVUNCU
Türkiye Fiziksel Tip ve Rehabilitasyon Dergisi , 2008,
Abstract: Disorders of the craniomandiubular muscles play an important role in the etiology of temporomandibular joint (TMJ) dysfunction. Muscles of the cervical region provide efficient functioning of the jaw muscles by contributing to the stabilization of the mandibula. Torticollis related to sternocleidomastoid muscle pathology may lead to TMJ dysfunction both by affecting cervical posture and by causing changes in adjacent bones. Turk J Phys Med Rehab 2004;54:36-8.
Craniocervical posture analysis in patients with temporomandibular disorder Análise da postura cranio-cervical em pacientes com disfun o temporomandibular  [cached]
DH Iunes,LCF Carvalho,AS Oliveira,D Bevilaqua-Grossi
Brazilian Journal of Physical Therapy , 2009,
Abstract: OBJECTIVE: To compare head positioning and cervical spine alignment between individuals with and without temporomandibular disorders (TMDs), by means of positional evaluation using photographs, radiographs and visual observation, and to investigate whether the type of TMD influences head posture and cervical spine positioning. METHODS: Ninety randomly chosen women were diagnosed using the research diagnostic criteria for TMDs (RDC/TMD) by a trained examiner and were divided into three groups: Group 1, with a diagnosis of myofascial dysfunction (group I of RDC axis I); Group 2, with mixed TMD (groups I, II and III of RDC axis I); and Control, without TMD. Following this, the participants were photographed in frontal and lateral views by a single examiner. To produce these photos, the following anatomical points were marked out on the skin: occipital protuberance, C4, C7, acromioclavicular joint and sternoclavicular joint. From these points, different angles were analyzed by means of the ALCimagem-2000 application. These same photos were then evaluated qualitatively (visual evaluation). Next, lateral teleradiography and radiography of the cervical spine was requested. The examiner was blind when analyzing the images. To compare the results, the chi-squared test and analysis of variance were used, with significance levels of 5%. RESULTS: Regardless of the method used, the results revealed that head and cervical spine posture did not differ between the groups with and without TMD, independent of the diagnostic group. CONCLUSION: The posture of individuals with myogenic or arthrogenous TMD does not differ from the posture of individuals without TMD. The presence of TMD does not influence the head and cervical spine posture. OBJETIVO: Comparar o posicionamento da cabe a e o alinhamento da coluna cervical em indivíduos com e sem DTM, por meio da avalia o postural por fotografias, radiografias e por observa o visual e verificar se o tipo de DTM influencia na postura da cabe a e no posicionamento da coluna cervical. MéTODOS: Noventa mulheres escolhidas aleatoriamente foram diagnosticadas por meio dos Critérios para Diagnóstico em Pesquisa para Disfun es Temporomandibulares (RDC/TMD) por um examinador treinado e divididas em três grupos: grupo 1, diagnóstico de disfun o miofascial (grupo I do eixo I do RDC); grupo 2, com DTM mista (grupo I, II e III do eixo I do RDC) e controle, sem DTM . Em seguida, foram fotografadas em vista anterior e em perfil por um único examinador. Para a realiza o dessas fotografias, foram demarcados sobre a pele os seguintes pontos
Craniocervical posture analysis in patients with temporomandibular disorder
Iunes, DH;Carvalho, LCF;Oliveira, AS;Bevilaqua-Grossi, D;
Brazilian Journal of Physical Therapy , 2009, DOI: 10.1590/S1413-35552009005000011
Abstract: objective: to compare head positioning and cervical spine alignment between individuals with and without temporomandibular disorders (tmds), by means of positional evaluation using photographs, radiographs and visual observation, and to investigate whether the type of tmd influences head posture and cervical spine positioning. methods: ninety randomly chosen women were diagnosed using the research diagnostic criteria for tmds (rdc/tmd) by a trained examiner and were divided into three groups: group 1, with a diagnosis of myofascial dysfunction (group i of rdc axis i); group 2, with mixed tmd (groups i, ii and iii of rdc axis i); and control, without tmd. following this, the participants were photographed in frontal and lateral views by a single examiner. to produce these photos, the following anatomical points were marked out on the skin: occipital protuberance, c4, c7, acromioclavicular joint and sternoclavicular joint. from these points, different angles were analyzed by means of the alcimagem-2000 application. these same photos were then evaluated qualitatively (visual evaluation). next, lateral teleradiography and radiography of the cervical spine was requested. the examiner was blind when analyzing the images. to compare the results, the chi-squared test and analysis of variance were used, with significance levels of 5%. results: regardless of the method used, the results revealed that head and cervical spine posture did not differ between the groups with and without tmd, independent of the diagnostic group. conclusion: the posture of individuals with myogenic or arthrogenous tmd does not differ from the posture of individuals without tmd. the presence of tmd does not influence the head and cervical spine posture.
Influencia de la postura corporal en la prevalencia de las disfunciones craneomandibulares Influence of body posture in the prevalence of craniomandibular dysfunction  [cached]
Ramón Fuentes F,Wolfgang Freesmeyer,Jorge Henríquez P
Revista médica de Chile , 1999,
Abstract: Background: Postural alterations of the shoulders, dorsal spine and hips could have an influence on the development of craniomandibular dysfunctions. Aim: To study the influence of body posture on the prevalence of craniomandibular dysfunction. Subjects and methods: One hundred thirty six dental students and 41 patients assisting to the temporomandibular joints (TMJ) clinic at the Freie Universit t at Berlin, were studied. Masticator, cervical muscles, temporomandibular joints and occlusions were clinically examined. The position of shoulders and hips was measured with the use of an acromiopelvimeter. Results: No relationship was found between postural alterations of the hips and shoulders, articular noises and sensibility or pain while palpating the temporomandibular joints. Among students, a relationship between postural alterations of the shoulders and the sensibility or pain while palpating the TMJ, was observed. When all muscles were considered, a significant relationship between asymmetric shoulders or hips and muscular pain while palpating was observed among students. Conclusions: Some symptoms, especially muscular sensibility is more pronounced in people with hip and shoulder asymmetries. This relation is more pronounced in dental students than in patients.
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