Forward Head Posture Correction Impact on Temporomandibular Dysfunction

Official title

Forward Head Posture Correction Impact on Temporomandibular Dysfunction: A Randomized Controlled Trial

Overview

The goal of this clinical trial is to test the effect of nerd neck correction on damaged jaw in people who suffers from jaw problems and nerd neck. The main question it aims to answer: * whether there are different effects of traditional nerd neck correction exercises, device correction method and dental splints on jaw features of pain and function. Participants will: * participants will be given the consent to sign first. * participants will be assessed to check jaw pain and function. * participants will be divided randomly into 3 groups. * Each group will be given the treatment sessions for 6 weeks. * participants will come back after 6 weeks for one last assessment. Researchers will compare traditional, new and dental treatment groups to see if there is improvement in jaw characteristics.

Detailed description

The relationship between the two conditions of forward head posture (FHP) and temporomandibular joint dysfunction (TMD) have been previously stated with comparing the craniocervical angle (CVA) of TMD patients to the healthy individuals, still a clear relationship couldn't be drawn due to different study limitations such as the lack of subdivision in the TMD patients based on their diagnostic subcategories in addition to, patients posture might have been altered while the photo was captured. Ever since, multiple researchers deliberately investigated the two conditions association and inferred the following: 1. FHP can be a risk factor resulting in TMD where any alteration in the head position produces more tension on the masticatory muscles by changing the mandible position 2. TMD origins from muscular component is more significant than articular component yet the correlation between head posture and TMD is still not clear enough, however, if FHP and myogenic TMD were linked preventive measures can be taken. recently, multiple studies established a relation between the occurrence of FHP in TMD patients which supported the hypothesized relation between them.

Till present, no study has investigated the FHP Denneroll cervical traction orthodontic (DCTO) correction impact alone on TMD and this is where the purpose of this study arises from.

Interventions

• Device Denneroll cervical traction orthodontic
  traction for 3 to 15 minutes once daily
• Other stretching and strengthening exercises
  strengthening exercises with 10 repetitions twice per day 3 times per week stretching exercises with hold for 20 to 30 seconds 3 repetitions daily
• Device Vacuum-formed soft occlusal splint
  2 mm thick elastic rubber sheets

Primary outcome measures

• Anamnestic questionnaire by Fonseca [Time frame: Baseline (pre-treatment) and week 7 (post-treatment)]
• Craniocervical angle - CVA [Time frame: Baseline (pre-treatment) and week 7 (post-treatment)]

Secondary outcome measures (3)

• Boley Gauge [Time frame: Baseline (pre-treatment) and week 7 (post-treatment)]
• Numerical Rating Scale (NRS) [Time frame: Baseline (pre-treatment) and week 7 (post-treatment)]
• Mandibular Opening [Time frame: Baseline (pre-treatment) and week 7 (post-treatment)]

Eligibility criteria

Inclusion criteria

• The participant experiencing one or more of TMD signs or symptoms and has been diagnosed with TMD beside having forward head posture with craniocervical (CVA) angle < 50.
• The study will be limited to the patients in the dental clinic of the university of Sharjah.
• Participants experiencing mild to moderate myogenic TMD with symptoms of orofacial pain and limited range of jaw opening.

Exclusion criteria

• Previous head, neck or TMJ traumas.
• History of temporomandibular joint surgery.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

United Arab Emirates · 1 center

• University of Sharjah — Sharjah city

Publications

• Lee WY, Okeson JP, Lindroth J. The relationship between forward head posture and temporomandibular disorders. J Orofac Pain. 1995 Spring;9(2):161-7. PMID 7488986
• Salkar RG, Radke UM, Deshmukh SP, Radke PM. Relationship between temporomandibular joint disorders and body posture. Int J Dent Health Sci. 2015;2(6):1523-30.
• Saddu SC, Dyasanoor S, Valappila NJ, Ravi BV. The Evaluation of Head and Craniocervical Posture among Patients with and without Temporomandibular Joint Disorders- A Comparative Study. J Clin Diagn Res. 2015 Aug;9(8):ZC55-8. doi: 10.7860/JCDR/2015/12830.6343. Epub 2015 Aug 1. PMID 26436048
• El-Hamalawy FA. Forward head correction exercises for management of myogenic tempromandibular joint dysfunction. 2011;7(8)
• Tang Y, Xu LL, Fan S. [Control study of forward head posture between patients with temporomandibular disorders and healthy people]. Shanghai Kou Qiang Yi Xue. 2021 Apr;30(2):173-176. Chinese. PMID 34109357
• Xiao CQ, Wan YD, Li YQ, Yan ZB, Cheng QY, Fan PD, Huang Y, Wang XY, Xiong X. Do Temporomandibular Disorder Patients with Joint Pain Exhibit Forward Head Posture? A Cephalometric Study. Pain Res Manag. 2023 Feb 2;2023:7363412. doi: 10.1155/2023/7363412. eCollection 2023. PMID 36776487
• Minervini G, Franco R, Marrapodi MM, Crimi S, Badnjevic A, Cervino G, Bianchi A, Cicciu M. Correlation between Temporomandibular Disorders (TMD) and Posture Evaluated trough the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): A Systematic Review with Meta-Analysis. J Clin Med. 2023 Apr 2;12(7):2652. doi: 10.3390/jcm12072652. PMID 37048735

Identifiers

NCT: NCT06123351 · FHP-TMD

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗