Neck Musculoskeletal Symptoms Among Turkish Endodontists (ENDO-NECK)

Analysis of Neck Musculoskeletal Symptoms, Functional Parameters, and Associated Factors in Turkish Endodontists

This observational study aims to evaluate the prevalence, severity, and characteristics of neck musculoskeletal symptoms among Turkish endodontists. Endodontists are exposed to prolonged static postures and repetitive movements during clinical procedures, which may increase the risk of neck-related disorders.

Participants will be asked to complete questionnaires regarding demographic characteristics, occupational factors, ergonomic conditions, and neck pain. In addition, physical assessments including cervical range of motion, muscle strength, endurance, posture, and proprioception will be performed using validated measurement tools.

The study also aims to identify factors associated with neck pain, such as working conditions, posture, and clinical experience. The findings may help improve preventive strategies, ergonomic recommendations, and rehabilitation approaches for dental professionals.

Study Overview

• Status: Not yet recruiting
• Conditions: Occupational Diseases; Neck Pain; Endodontics; Dentistry; Neck Pain Musculoskeletal; Musculoskeletal Disorder of the Neck; Occupational Musculoskeletal Disorders; Musculoskeletal Assessment; Musculoskeletal Disorders (MSDs)
• Intervention / Treatment: Other: No intervention (observational study)

Detailed Description

Musculoskeletal disorders are among the most common occupational health problems in dental professionals, particularly affecting the cervical region. Endodontists are at increased risk due to prolonged static postures, repetitive fine motor movements, and the use of magnification devices such as microscopes.

This observational cross-sectional study aims to investigate neck musculoskeletal symptoms among Turkish endodontists and to analyze their relationship with functional parameters and occupational factors.

Participants aged 25-65 years who are actively working as endodontists in Turkey will be included. After providing informed consent, participants will complete a structured questionnaire including demographic data, occupational characteristics, ergonomic conditions, and neck pain parameters.

Physical evaluations will include:

• Cervical range of motion measured with a digital inclinometer,
• Isometric cervical muscle strength assessed using a handheld dynamometer,
• Deep cervical flexor muscle endurance evaluated using the craniocervical flexion test,
• Cervical joint position sense assessed using an inclinometer,
• Postural assessment using photographic analysis and a mobile posture analysis application.

Functional disability will be evaluated using the Neck Disability Index (NDI).

The primary objective is to determine the prevalence and severity of neck pain. Secondary objectives include identifying associated risk factors such as posture, working duration, ergonomic conditions, and clinical experience, as well as evaluating the relationship between neck pain and functional and biomechanical parameters.

The results of this study are expected to contribute to the understanding of occupational risk factors in endodontists and to guide preventive and therapeutic strategies aimed at reducing neck-related musculoskeletal disorders.

• Study Type: Observational
• Enrollment (Estimated): 120

Contacts and Locations

• Study Contact: Name: Kubra Neslihan Kurt Oktay, MD; Phone Number: +905352916609; Email: drneslihankurt@gmail.com

Study Locations

• Turkey (Türkiye)
  • Uskudar
    • Istanbul, Uskudar, Turkey (Türkiye), 34860
      • University of Health Sciences, Haydarpasa Numune Training and Research Hospital
      • Contact: Kubra Neslihan Kurt Oktay, MD; Phone Number: +905352916609; Email: drneslihankurt@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

The study population consists of actively practicing endodontists in Turkey, aged 25 to 65 years, working in public institutions, university hospitals, or the private sector. Participants with and without neck pain will be included to evaluate neck musculoskeletal symptoms, functional parameters, and associated occupational and ergonomic factors.

Description

Inclusion Criteria:

• Aged 25 to 65 years
• Actively practicing as an endodontist in Turkey in public institutions, university hospitals, or the private sector
• Willing and able to provide informed consent
• Endodontists with or without neck pain

Exclusion Criteria:

• History of cervical spine surgery within the last 3 months
• History of cervical spine infection within the last 3 months (e.g., spondylodiscitis)
• History of malignancy involving the cervical region
• Spinal cord compression due to tumor or another cause
• Presence of neurological deficit
• Inflammatory disease involving the cervical region, such as rheumatoid arthritis
• Use of muscle relaxant medication within the last 1 week

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Turkish Endodontists; Endodontists aged 25 to 65 years who are actively practicing in Turkey and voluntarily agree to participate in the study. Participants will complete questionnaires on demographic, occupational, ergonomic, and neck pain-related factors, and will undergo physical assessments including cervical range of motion, isometric muscle strength, muscle endurance, posture, proprioception, and neck disability evaluation. Participants may later be analyzed in subgroups according to occupational factors such as microscope use.

Other: No intervention (observational study); This is an observational study with no therapeutic or experimental intervention. Participants will undergo questionnaire-based evaluations and physical assessments including cervical range of motion, muscle strength, endurance, posture, and proprioception measurements.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Prevalence and Severity of Neck Pain	Neck pain will be assessed using a self-reported questionnaire evaluating the presence, frequency, duration, and intensity of pain. Pain intensity will be measured using a numeric rating scale (0-10), where higher scores indicate greater pain severity.	Baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Neck Disability Index (NDI) Score	Functional disability related to neck pain will be assessed using the Neck Disability Index (NDI). The NDI consists of 10 items evaluating daily activities, each scored from 0 to 5. Total scores range from 0 to 50, with higher scores indicating greater disability.	Baseline
Cervical Range of Motion	Cervical flexion, extension, lateral flexion, and rotation will be measured using the MicroFET 3 digital inclinometer. Range of motion values will be recorded in degrees for each movement direction.	Baseline
Cervical Isometric Muscle Strength	Maximal isometric strength of cervical flexor, extensor, and lateral flexor muscles will be measured using the MicroFET 3 handheld dynamometer. Measurements will be performed in standardized positions and recorded.	Baseline
Deep Cervical Flexor Muscle Endurance	Endurance of deep cervical flexor muscles will be assessed using the craniocervical flexion test with a pressure biofeedback unit. Performance will be recorded based on the ability to maintain target pressure levels.	Baseline
Cervical Postural Parameters	Postural alignment including craniovertebral angle, head tilt angle, and cervicothoracic angle will be assessed using standardized photographic analysis with a smartphone-based posture assessment application.	Baseline
Cervical Joint Position Sense	Cervical proprioception will be assessed using joint position error measurements with an inclinometer during flexion, extension, rotation, and lateral flexion movements.	Baseline
Occupational and Ergonomic Factors Associated with Neck Pain	Associations between neck pain and occupational and ergonomic factors, including clinical workload, working duration, sitting posture, use of magnification systems or an operating microscope, four-handed dentistry, assistant support, awkward working positions, and workplace conditions, will be analyzed based on questionnaire data.	Baseline

Collaborators and Investigators

• Sponsor: Atlas University

Study record dates

Study Major Dates

• Study Start (Estimated): May 1, 2026
• Primary Completion (Estimated): May 1, 2027
• Study Completion (Estimated): August 1, 2027

Study Registration Dates

• First Submitted: April 1, 2026
• First Submitted That Met QC Criteria: April 1, 2026
• First Posted (Actual): April 8, 2026

Study Record Updates

• Last Update Posted (Actual): April 8, 2026
• Last Update Submitted That Met QC Criteria: April 1, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Posture; Neck Pain; Ergonomics; Neck Disability Index; Musculoskeletal Pain; Occupational Health; Cervical Spine; Forward Head Posture; Dentists; Musculoskeletal Symptoms; Work-Related Musculoskeletal Disorders; Cervical Range of Motion; Endodontists; Cervical Isometric Muscle Strength; Neck Muscle Endurance; Cervical Muscle Strength
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Muscular Diseases; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Musculoskeletal Pain; Musculoskeletal Diseases; Neck Pain; Occupational Diseases; Investigative Techniques; Methods; Observation
• Other Study ID Numbers: ISTU-ENDO-NECK-2024-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared due to privacy and confidentiality considerations, as well as the absence of prior participant consent for data sharing.

Drug and device information, study documents

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