National Clinical Research Center for Oral Diseases, State Key Laboratory of Oral Diseases, Department of Head and Neck Oncology Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
National Clinical Research Center for Oral Diseases, State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
Pain Res Manag. 2023 Feb 2;2023:7363412. doi: 10.1155/2023/7363412. eCollection 2023.
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.
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.
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 ( = 3.099), OPT/RL ( = 2.117), and NSL/C2' ( = 4.646) than the patients without joint pain after adjusting for confounding variables ( < 0.05).
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.
评估患有或不患有颞下颌关节紊乱（TMD）的个体的头颈部姿势，并评估疼痛、症状严重程度和姿势之间的相关性。
共纳入 384 名患者（男 129 名，女 255 名）。采用 Fonseca 病史指数（FAI）评估 TMD 的严重程度和患病率以及颞下颌关节（TMJ）疼痛的存在情况。患者被分为三组：TMD 无 TMJ 疼痛组、TMD 伴 TMJ 疼痛组。随后，将 TMJ 疼痛患者进一步分为轻度 TMD 和中重度 TMD 组。通过头颅侧位片追踪 9 个参数来描述头颈部姿势。
伴 TMJ 疼痛的 TMD 患者的前伸头位（FHP）高于无 TMJ 疼痛和 TMD 无 TMJ 疼痛的患者。无 TMJ 疼痛的 TMD 患者与 TMD 无 TMJ 疼痛的患者之间无显著性差异。在 TMJ 疼痛的 TMD 患者中，中重度 TMD 患者的 FHP 大于轻度 TMD 患者。关节疼痛的 TMD 患者的 CVT/RL（ = 3.099）、OPT/RL（ = 2.117）和 NSL/C2'（ = 4.646）均大于无关节疼痛的患者，调整混杂变量后差异具有统计学意义（ < 0.05）。
与其他组相比，TMJ 疼痛的 TMD 患者表现出更大的 FHP，并且随着 TMD 严重程度的增加，FHP 在男性患者中变得更为显著，表明 FHP 可能在 TMJ 疼痛的发展中起重要作用。在 TMD 的临床评估中，可能需要考虑患者异常的头颈部姿势。
