Associations Between Posture And Temporomandibular Disorders: A Systematic Review Of Observational Studies Published Since 2010

Authors: Bizzarri, P1; Scafoglieri, A1; Perinetti, G2; Lobbezoo, F3; Manfredini, D4 Affiliations:

1: Vrije Universiteit Brussel (VUB), Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy

2: Private Practitioner

3: Department of Orofacial Pain and Dysfunction, Faculty of Dentistry, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

4: School of Dentistry, University of Siena

Aim of investigation:
The scientific community has identified the biopsychosocial model as the best approach to evaluate and manage individuals suffering from temporomandibular disorders (TMD). However, in orofacial and musculoskeletal medicine several professionals support the clinical role of postural approaches in evaluating and treating patients. We aimed to search possible evidence regarding the presence of postural alterations in TMD patients.

Methods:
Observational studies comparing the presence and the magnitude of body misalignment and postural platform abnormalities in adult patients with temporomandibular disorders, diagnosed through Research Diagnostic Criteria (RDC/TMD) or Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) to matched control groups of individuals without TMDs were included, following the PRISMA statement. Articles indexed in PubMed since January 2010 were screened and data were extracted.

Results:
The electronic search strategy identified 498 articles. 12 were finally included in this review.

High heterogeneity was observed in populations and settings. 49 different outcome measures were collected regarding several body regions, based on radiological, photogrammeric and postural platform measurements. Most collected outcome measures were related to head inclination, C0-C1 and C1-C2 distances, and cervical alignment.

The vast majority of the included studies rejects an association between body alignment, baropodometric features and temporomandibular disorders, reporting similar values between experimental and control groups. The very few statistically significant differences observed in single studies appeared contradictory, possibly related to confounders and within normative values.

Conclusions:
Scientific literature published since 2010 rejects a clinical and predictable interrelationship between temporomandibular disorders and posture.

Acknowledgements and/or Funding Source: None