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Static sagittal cervical alignment, pain, and jaw functional limitation across temporomandibular disorder subtypes: a
Tolgahan Kara1, Nursena Ünlü Kuzu2, Elif Doğan2
1Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tokat Gaziosmanpaşa University, Tokat, Turkey. dt_tolgahan@hotmail.com.
Background:
This study aimed to compare cervical sagittal alignment among temporomandibular disorder subtypes and to investigate the relationships between cervical alignment parameters, temporomandibular joint pain, neck pain, and jaw functional limitation.
Materials And Methods:
A total of 118 participants, including patients diagnosed with temporomandibular disorder (TMD) and healthy controls, were included in the study. The study was conducted between January 2, 2025, and July 2, 2025. Based on the DC/TMD criteria, participants were classified into four groups: healthy controls, myalgia, disc displacement with reduction (DDwR), and disc displacement without reduction (DDwoR). TMJ pain and cervical pain intensities were assessed using VAS, while jaw functional limitation was evaluated using the jaw functional limitation scale-8 (JFLS-8). Cervical sagittal alignment was assessed on lateral cephalometric radiographs using the C2-C7 Cobb angle, POCA, and O-C2 angle. Multivariate analysis of variance and correlation analyses were performed.
Results:
TMJ pain intensity and JFLS-8 scores were significantly higher in the DDwoR group compared with the control group and other TMD subtypes (p < 0.001). No significant differences were observed among groups in terms of C2-C7 Cobb angle, POCA, or O-C2 angle (p > 0.05). Statiscally significant but weak positive correlations were found between TMJ pain and neck pain, as well as between TMJ pain and jaw functional limitation (p < 0.001). A weak positive correlation was initially observed between TMJ pain and the C2-C7 Cobb angle; however, this association did not remain statistically significant after correction for multiple comparisons.
Conclusion:
Although TMD subtypes differ significantly in TMJ pain severity and jaw functional limitation, cervical sagittal alignment parameters do not significantly distinguish these groups. These findings suggest that sagittal cervical alignment has a limited role in explaining TMD-related symptom severity and highlight the multifactorial nature of temporomandibular disorders.
