Postural alterations as a risk factor for temporomandibular disorders.

Area of Science:

• Orthodontics and Dentofacial Orthopedics
• Physical Therapy
• Biomechanical Engineering

Background:

• Temporomandibular disorders (TMD) are a group of conditions affecting the jaw joint and muscles.
• Postural alterations have been anecdotally linked to TMD, but robust evidence is limited.
• Adolescents seeking dental care represent a population where early identification of risk factors is important.

Purpose of the Study:

• To determine the frequency of TMD in adolescents aged 10-15 years.
• To investigate the association between specific postural alterations and TMD, particularly muscular TMD.
• To identify common postural deviations in adolescents with and without TMD.

Main Methods:

• A cohort of 243 adolescents (mean age 12.6 years) seeking dental care was assessed.
• Diagnosis of TMD was performed using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD).
• Static postural analysis was conducted using standardized photographic methods (Kendall's model) by a physiotherapist.

Main Results:

• Significant associations were found between muscular TMD and alterations in spinal curves (OR: 3.40), head posture (OR: 2.44), and lower limbs (OR: 2.22).
• Common postural issues included lumbar hyperlordosis (23.30-32.78%), forward head posture (39.85-52.45%), and genu valgum (33.08-45.90%).
• These alterations were more prevalent in the group with muscular TMD compared to the control group.

Conclusions:

• Postural deviations in head, spine, and lower limbs are significant risk factors for developing muscular TMD in adolescents.
• Lumbar hyperlordosis, forward head posture, and genu valgus are the most frequent postural alterations associated with TMD.
• Integrating postural assessment into dental care may aid in the early detection and prevention of TMD.