Postural Analysis in Temporomandibular Joint Dysfunction (TMJD) Patients: Correlation With Head and Neck Positioning

The relationship between head-neck posture and temporomandibular joint dysfunction (TMJD) remains a topic of controversy, with existing studies reporting inconsistent findings. This study aimed to investigate this relationship by comparing specific postural angles in TMJD patients and healthy controls.

A case-control study included 65 TMJD patients and 65 healthy controls (aged 18-50), analyzing head positioning angles (craniohorizontal angle [CHA] and craniovertebral Angle [CVA]) using anatomical markers in photographs processed with Adobe Photoshop. Data were analyzed using SPSS, employing t-tests, chi-square tests, and multiple linear regression.

The final analyzed sample consisted of 43 TMJD patients and 40 controls after applying inclusion/exclusion criteria and ensuring data completeness. The TMJD group exhibited significantly lower mean CVA (41.1° ± 6.61°) compared to controls (56.83° ± 4.33°; p = 0.027), indicating a more forward head posture. The difference in CHA was not statistically significant. Regression analysis identified that a lower CVA (i.e., worse posture) was significantly associated with older age (β = -0.45, p  < 0.01), bruxism (β = -0.32, p  < 0.01), and clenching (β = -0.28, p  < 0.05). These factors explained 77.8% of the variance in CVA (R ² = 0.778).

These findings suggest that postural assessment of the CVA and the clinical management of parafunctional habits like bruxism and clenching should be integrated into the comprehensive evaluation and treatment of patients with TMJD.