Association between severity of the temporomandibular disorder, neck pain, and mandibular function impairment

Abstract

Purpose: to investigate the possible association between the severity of the temporomandibular disorder, cervical pain, and mandibular function impairment. Methods: is a cross-sectional, descriptive study, conducted with 32 individuals with temporomandibular disorder, categorized by degree of severity, according to the Fonseca Index. Using the diagnosis criteria for temporomandibular disorder, the likely etiological factors for the disorder were established, as well as the intensity of the functional disability, resulting from cervical pain and of the mandibular impairment. The data obtained were statistically treated, adopting the significance level of 5%. Results: the mean age was 33.8 years, 90.6% being females. As for the degree of disorder, 56.3% presented severe TMD, followed by 28.1% showing a moderate one. The myogenic etiology was present in 93.7% of the patients. Cervical pain was present in 90.6% of them, of which, 59.4% presented a mild disability, and 25%, a moderate one. Considering the mandibular function, 46.9% of the patients presented a low, 40.6%, a moderate, and 12.5%, a severe impairment. There was a statistically significant association between cervical pain and mandibular function (p = 0.011). However, although there was an increase in cervical disability and in mandibular impairment as the severity of the TMD also increased, these associations were not statistically significant (p = 0.178 and p = 0.102, respectively). Conclusion: it can be stated that there is a higher prevalence of severe TMD and of myogenic origin, and that cervical pain influences, directly, the mandibular function, which is not necessarily related to the severity of the temporomandibular alteration. Likewise, such severity does not present a relationship to mandibular function impairment either.

Prevalence of cervical alterations in patients with temporomandibular dysfunction in a specialized referral service

“…Hormonal factors are also involved, since estrogen increases susceptibility to painful stimuli by modulating the limbic system. Nunes, et al, (2020) and Viana, et al, (2015) also reported ligament laxity resulting from hormonal changes, and more flexible and less dense joints. Many authors, such as Wiest, et al, (2019) and Weber, et al, (2012), evaluated only female patients, as they are the most affected by TMD.…”

“…It is necessary to be aware of the involvement of psychosocial, emotional, cognitive, and social factors since emotional substrates are present in many TMD cases. Physical examination consists of palpating the TMJ and associated muscles, measuring active movement, and analyzing joint sound (Godinho & Cabral, 2019;Weber, et al, 2012;Nunes, et al, 2020).…”

“…The close relationship of the TMJ with the cervical musculature can lead to compensations and corrections that characterize the axis of dysfunction in its ascending or descending character. The criteria of standardized instruments used for evaluating TMD, such as the DC/TMD, help verify that TMD is either the cause of the sequelae in the other segments, as described above, or a consequence of ascending impairment (Nunes, et al, 2020) Understanding the role of myofascial chains is of utmost importance in relating symptomatic aspects to structural imbalances. It is essential to study TMDs to address their influence, which is not restricted to the orofacial region and may affect cervical muscles.…”

Occurrence of Cervical Spine Pain and Its Intensity in Young People with Temporomandibular Disorders

“…In the scientific literature, there is information on the relationship between cervical spine pain and temporomandibular disorders, which may include biomechanical, neurophysiological, or neuroanatomical aspects [16]. The connection of the cervical spine with the temporomandibular joints shows that they have a direct impact on each other's functioning.…”

Occurrence of Cervical Spine Pain and its Intensity in Young People with Temporomandibular Disorders: A Pilot Study

“…In the scientific literature contains information on the relationship between cervical spine pain and temporomandibular disorders, which may include biomechanical, neurophysiological or neuroanatomical aspects [13]. The connection of the cervical spine with the temporomandibular joints shows that they have a direct impact on each otherʹs functioning.…”