The Association Between Head and Cervical Posture and Temporomandibular Disorders: A Systematic Review

Aims: To carry out a systematic review to assess the evidence con-cerning the association between head and cervical posture and temporomandibular disorders (TMD). Methods: A search of Medline, Pubmed, Embase, Web of Science, Lilacs, and Cochrane Library databases was conducted in all languages with the help of a health sciences librarian. Key words used in the search were pos-ture, head posture, cervical spine or neck, vertebrae, cervical lor-dosis, craniomandibular disorders or temporomandibular disor-ders, temporomandibular disorders, and orofacial pain or facial pain. Abstracts which appeared to fulfill the initial selection crite-ria were selected by consensus. The original articles were retrieved and evaluated to ensure they met the inclusion criteria. A method-ological checklist was used to evaluate the quality of the selected articles and their references were hand-searched for possible miss-ing articles. Results: Twelve studies met all inclusion criteria and were analyzed in detail for their methodology and information quality. Nine articles that analyzed the association between head posture and TMD included patients with mixed TMD diagnosis; 1 article differentiated among muscular, articular, and mixed symp-tomatology; and 3 articles analyzed information from patients with only articular problems. Finally, 2 studies evaluated the asso-ciation between head posture and TMD in patients with muscular TMD. Several methodological defects were noted in the 12 stud-ies. Conclusion: Since most of the studies included in this system-atic review were of poor methodological quality, the findings of the studies should be interpreted with caution. The association between intra-articular and muscular TMD and head and cervical posture is still unclear, and better controlled studies with compre-hensive TMD diagnoses, greater sample sizes, and objective pos-ture evaluation are necessary.

cervical lordosis; head posture; systematic review; tem-poromandibular disorders

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