Additional Effect of Forward Head Posture Correction on Temporomandibular Dysfunction

Additional Effect of Forward Head Posture Correction on Temporomandibular Dysfunction: A Randomized Controlled Trial.

The goal of this clinical trial is to test the additional correction effect of nerd neck on damaged jaw in people who suffers from jaw problems and nerd neck at the same time. The main question it aims to answer:

• whether the additional correction of nerd neck impact the 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 2 groups.
• Each group will be given the treatment sessions for 6 weeks.
• participants will come back after 6 weeks for another last assessment. Researchers will compare regular treatment for Jaw with new device, regular only and dental treatment groups to see if there is improvement in jaw characteristics.

Study Overview

• Status: Recruiting
• Conditions: Temporomandibular Disorder; Forward Head Posture
• Intervention / Treatment: Device: Conservative with Denneroll; Other: Conservative

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 suspected relation between them but without a clear association. Till present, no study has investigated the additional effect of FHP DCTO correction impact on myogenic TMD, and this is where the purpose of this study arises from.

• Study Type: Interventional
• Enrollment (Estimated): 42
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Tamer Shousha; Email: Tshousha@sharjah.ac.ae
• Study Contact Backup: Name: Shima AH Mohammadzadeh; Phone Number: +971503077039; Email: U22103961@sharjah.ac.ae

Study Locations

• United Arab Emirates
  • Sharjah, United Arab Emirates, 27272
    • Recruiting
    • University of Sharjah
    • Contact: Tamer Shousha; Email: Tshousha@sharjah.ac.ae
    • Contact: Shima A Mohammad Zadeh; Phone Number: 00971503077039; Email: U22103961@sharjah.ac.ae
    • Principal Investigator: Shima A Mohammad Zadeh
  • Sharjah, United Arab Emirates, 0000
    • Recruiting
    • University of Sharjah
    • Contact: Tamer Shousha; Email: Tshousha@sharjah.ac.ae

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

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.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Conservative with Denneroll; Participants will be supine lining with the orthotic will be placed under participants' neck. Treatment session time begin with 3 minutes then increase of 2-3 minutes until they reach 15 to 20 minutes in each session with the conservative management for TMD.	Device: Conservative with Denneroll; Denneroll cervical traction orthodontic traction for 3 to 15 minutes once daily with conservative management of stretching and relaxation.
Active Comparator: Conservative; consists of teaching the patient the relaxed jaw position and stretching exercises for masseter and pterygoid muscles with hold of 20-30 seconds and 3-5 repetitions. In addition to placebo traction.	Other: Conservative; conservative management of stretching and relaxation with placebo traction.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Anamnestic questionnaire by Fonseca	To evaluate TMD by 10 questions with their corresponding scores from 0 to 10	Baseline (pre-treatment), 3rd and week 7 (post-treatment)
Craniocervical angle - CVA	photographic method to evaluate the angle where an angle less than 50 degrees will be considered as forward head posture	Baseline (pre-treatment), 3rd and week 7 (post-treatment)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Boley Gauge	Electronic Digital Caliper to assess mouth opening (active/passive)	Baseline (pre-treatment), 3rd and week 7 (post-treatment)
Visual Analog Scale (VAS)	0-10 scale (zero represents no pain and 10 is the worst pain ever) to record orofacial pain	Baseline (pre-treatment), 3rd and week 7 (post-treatment)
Mandibular Opening	Tape to measure the distance between the incisal edges of upper and lower teeth	Baseline (pre-treatment), 3rd and week 7 (post-treatment)

Collaborators and Investigators

• Sponsor: Shima Abdollah Mohammad Zadeh

Publications and helpful links

General 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.
• 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.
• 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.
• 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.
• 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.

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2024
• Primary Completion (Estimated): February 1, 2025
• Study Completion (Estimated): December 1, 2025

Study Registration Dates

• First Submitted: November 24, 2023
• First Submitted That Met QC Criteria: November 24, 2023
• First Posted (Actual): December 5, 2023

Study Record Updates

• Last Update Posted (Actual): May 23, 2024
• Last Update Submitted That Met QC Criteria: May 22, 2024
• Last Verified: May 1, 2024

More Information

Terms related to this study

• Keywords: Pain; Traction; conservative treatment; Temporomandibular dysfunction
• Additional Relevant MeSH Terms: Joint Diseases; Musculoskeletal Diseases; Muscular Diseases; Stomatognathic Diseases; Jaw Diseases; Craniomandibular Disorders; Mandibular Diseases; Myofascial Pain Syndromes; Temporomandibular Joint Disorders; Temporomandibular Joint Dysfunction Syndrome
• Other Study ID Numbers: Added FHP correction on TMD

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: No plan to make individual participant data (IPD) available to other researchers.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No