An Investigation of Cranio-Cervico-Mandibular Factors Predicting the Severity of Temporomandibular Disorders

This cross-sectional study will examine the relationship between mandibular dysfunction, cervical joint position sense, craniovertebral angle, neck pain, and temporomandibular dysfunction (TMD) severity. TMD severity, mandibular function, cervical proprioception, craniovertebral angle, and neck pain history will be assessed using standardized clinical tools and questionnaires. The study will evaluate the associations between these variables and determine the factors that may predict TMD severity.

Study Overview

• Status: Recruiting
• Conditions: Temporomandibular Disorder
• Intervention / Treatment: Other: Assessments

• Study Type: Observational
• Enrollment (Estimated): 60

Contacts and Locations

• Study Contact: Name: Sevilay Seda BAŞ, PhD; Phone Number: +90 (312) 906 1683; Email: ssbas@aybu.edu.tr

Study Locations

• Turkey (Türkiye)
  • Ankara, Turkey (Türkiye)
    • Recruiting
    • Ankara Yıldırım Beyazıt University, Department of Physiotherapy and Rehabilitation
    • Contact: Sevilay Seda BAŞ; Phone Number: +9 0 (312) 906 1683; Email: ssbas@aybu.edu.tr

Participation Criteria

Eligibility Criteria

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

• Sampling Method: Non-Probability Sample

Study Population

Adults aged 18 years or older with a Fonseca Anamnestic Index (FAI) score of 20 or higher who gave written consent were included. Participants were people with jaw (TMJ) and/or neck complaints. People were excluded if they had recent treatment (last 6 months) for the jaw or neck, used pain or muscle relaxant drugs, had previous neck or jaw surgery or major trauma, jaw dislocation or subluxation, missing teeth or dental prostheses, or neurological, rheumatologic, or systemic inflammatory diseases.

Description

Inclusion Criteria:

• Fonseca Anamnestic Index score > 15
• aged 18 years and older

Exclusion Criteria:

• Received medical, orthodontic, or physiotherapy treatment targeting the temporomandibular joint and/or cervical region within the past six months
• used analgesic, anti-inflammatory, or muscle relaxant medications
• history of cervical spine or cranio-cervical surgery or major trauma
• a history of facial or TMJ trauma, TMJ subluxation or dislocation
• partial or complete dental prostheses
• had missing teeth
• neurological, rheumatological, or systemic inflammatory diseases

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
TMD Symptomatic Participants; Participants with temporomandibular dysfunction (TMD) symptoms will be included in the study. All participants will undergo clinical and questionnaire-based assessments to evaluate mandibular function, cervical joint position sense, craniovertebral angle, neck pain history, and TMD severity.	Other: Assessments; No intervention was applied.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Temporomandibular Dysfunction Severity	TMD severity will be assessed using the Fonseca Anamnestic Index, which evaluates the severity of temporomandibular dysfunction symptoms. It is a 10-item self-report questionnaire. Each item is scored as "Yes" (10 points), "Sometimes" (5 points), or "No" (0 points), with a total score calculated by summing all items.	Single assessment at baseline (cross-sectional evaluation)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cervical Extension Joint Position Sense	Cervical extension joint position sense will be assessed in a sitting position using an Acumar dual digital inclinometer. Participants will be asked to actively move their neck to 30° of cervical extension, memorize the target position, and then reproduce the same angle. The procedure will be repeated three times, and the average absolute error will be recorded.	Single assessment at baseline (cross-sectional evaluation)
Cervical Flexion Joint Position Sense	Cervical flexion joint position sense will be assessed in a sitting position using an Acumar dual digital inclinometer. Participants will be asked to actively move their neck to 30° of cervical flexion, memorize the target position, and then reproduce the same angle. The procedure will be repeated three times, and the average absolute error will be recorded.	Single assessment at baseline (cross-sectional evaluation)
Cervical Lateral Flexion Joint Position Sense	Cervical lateral flexion joint position sense will be assessed in a sitting position using an Acumar dual digital inclinometer. Participants will be asked to actively move their neck to 30° of lateral flexion, memorize the target position, and then reproduce the same angle. The procedure will be repeated three times, and the average absolute error will be recorded.	Single assessment at baseline (cross-sectional evaluation)
Cervical Rotation Joint Position Sense	Cervical rotation joint position sense will be assessed in a supine position using an Acumar dual digital inclinometer. Participants will be asked to actively rotate their head to 50° of cervical rotation, memorize the target position, and then reproduce the same angle. The procedure will be repeated three times, and the mean absolute error will be recorded.	Single assessment at baseline (cross-sectional evaluation)
Craniovertebral Angle	Craniovertebral angle will be measured using a two-dimensional image analysis method with Kinovea software from standardized lateral photographs. The tragus and C7 vertebra will be used as anatomical reference points to calculate the angle, and the mean of three measurements will be recorded for each participant.	Single assessment at baseline (cross-sectional evaluation)
Neck Musculoskeletal Symptoms	Musculoskeletal symptoms will be assessed using the Standardized Nordic Musculoskeletal Questionnaire. The questionnaire evaluates the presence of symptoms in different body regions over the past 12 months and past 7 days. Only neck pain-related variables will be used for analysis in line with the study objectives, while other data will be reported descriptively.	Single assessment at baseline (cross-sectional evaluation)
Mandibular Function Impairment Questionnaire	Mandibular function will be assessed using the Mandibular Function Impairment Questionnaire (MFIQ). The MFIQ is a 17-item self-report scale evaluating functional limitations during activities such as chewing, speaking, and yawning. Each item is scored on a 0-4 Likert scale, with higher scores indicating greater impairment.	Single assessment at baseline (cross-sectional evaluation)

Collaborators and Investigators

• Sponsor: sevilay seda bas

Study record dates

Study Major Dates

• Study Start (Actual): June 19, 2026
• Primary Completion (Estimated): July 10, 2026
• Study Completion (Estimated): July 10, 2026

Study Registration Dates

• First Submitted: June 18, 2026
• First Submitted That Met QC Criteria: June 18, 2026
• First Posted (Actual): June 24, 2026

Study Record Updates

• Last Update Posted (Actual): June 24, 2026
• Last Update Submitted That Met QC Criteria: June 18, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Stomatognathic Diseases; Muscular Diseases; Joint Diseases; Jaw Diseases; Mandibular Diseases; Craniomandibular Disorders; Temporomandibular Joint Disorders
• Other Study ID Numbers: 26.10.2024-10/1051

Drug and device information, study documents

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