Jaw dysfunction is associated with neck disability and muscle tenderness in subjects with and without chronic temporomandibular disorders

A Silveira, I C Gadotti, S Armijo-Olivo, D A Biasotto-Gonzalez, D Magee, A Silveira, I C Gadotti, S Armijo-Olivo, D A Biasotto-Gonzalez, D Magee

Abstract

Purpose: Tender points in the neck are common in patients with temporomandibular disorders (TMD). However, the correlation among neck disability, jaw dysfunction, and muscle tenderness in subjects with TMD still needs further investigation. This study investigated the correlation among neck disability, jaw dysfunction, and muscle tenderness in subjects with and without chronic TMD. Participants. Forty females between 19 and 49 years old were included in this study. There were 20 healthy controls and 20 subjects who had chronic TMD and neck disability.

Methods: Subjects completed the neck disability index and the limitations of daily functions in TMD questionnaires. Tenderness of the masticatory and cervical muscles was measured using an algometer.

Results: The correlation between jaw disability and neck disability was significantly high (r = 0.915, P < 0.05). The correlation between level of muscle tenderness in the masticatory and cervical muscles with jaw dysfunction and neck disability showed fair to moderate correlations (r = 0.32-0.65).

Conclusion: High levels of muscle tenderness in upper trapezius and temporalis muscles correlated with high levels of jaw and neck dysfunction. Moreover, high levels of neck disability correlated with high levels of jaw disability. These findings emphasize the importance of considering the neck and its structures when evaluating and treating patients with TMD.

Figures

Figure 1
Figure 1
PPT points evaluated (♦ temporalis muscle, ■ masseter muscle, ▲ sternocleidomastoid muscle, and X upper trapezius muscle).

References

    1. Kraus S. Temporomandibular disorders, head and orofacial pain: cervical spine considerations. Dental Clinics of North America. 2007;51(1):161–193. doi: 10.1016/j.cden.2006.10.001.
    1. Padamsee M., Mehta N., Forgione A., Bansal S. Incidence of cervical disorders in a TMD population. Journal of Dental Rresearch. 1994;73:p. 186.
    1. Perinetti G. Correlations between the stomatognathic system and body posture: biological or clinical implications? Clinics. 2009;64(2):77–78. doi: 10.1590/S1807-59322009000200002.
    1. Wiesinger B., Malker H., Englund E., Wänman A. Does a dose-response relation exist between spinal pain and temporomandibular disorders? BMC Musculoskeletal Disorders. 2009;10, article 28 doi: 10.1186/1471-2474-10-28.
    1. Oliveira-Campelo N. M., Rubens-Rebelatto J., Martín-Vallejo F. J., Alburquerque-Sendín F., Fernández-De-Las-Peñas C. The immediate efects of atlanto-occipital joint manipulation and suboccipital muscle inhibition technique on active mouth opening and pressure pain sensitivity over latent myofascial trigger points in the masticatory muscles. Journal of Orthopaedic and Sports Physical Therapy. 2010;40(5):310–317. doi: 10.2519/jospt.2010.3257.
    1. Ciancaglini R., Testa M., Radaelli G. Association of neck pain with symptoms of temporomandibular dysfunction in the general adult population. Scandinavian Journal of Rehabilitation Medicine. 1999;31(1):17–22. doi: 10.1080/003655099444687.
    1. Piekartz H. V., Bryden L. Craniofacial Dysfunction & Pain: Manual Therapy, Assessment and Management. London, UK: Butterworth Heinemann; 2001.
    1. Wänman A. The relationship between muscle tenderness and craniomandibular disorders: a study of 35-year-olds from the general population. Journal of orofacial pain. 1995;9(3):235–243.
    1. Stiesch-Scholz M., Fink M., Tschernitschek H. Comorbidity of internal derangement of the temporomandibular joint and silent dysfunction of the cervical spine. Journal of Oral Rehabilitation. 2003;30(4):386–391. doi: 10.1046/j.1365-2842.2003.01034.x.
    1. de Wijer A. Neck pain and temporomandibular dysfunction. Nederlands Tijdschrift voor Tandheelkunde. 1996;103(7):263–266.
    1. de Laat A., Meuleman H., Stevens A., Verbeke G. Correlation between cervical spine and temporomandibular disorders. Clinical Oral Investigations. 1998;2(2):54–57. doi: 10.1007/s007840050045.
    1. Fink M., Tschernitschek H., Stiesch-Scholz M. Asymptomatic cervical spine dysfunction (CSD) in patients with internal derangement of the temporomandibular joint. Cranio. 2002;20(3):192–197.
    1. Inoue E., Maekawa K., Minakuchi H., et al. The relationship between temporomandibular joint pathosis and muscle tenderness in the orofacial and neck/shoulder region. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 2010;109(1):86–90. doi: 10.1016/j.tripleo.2009.07.050.
    1. Greenspan J. D., Slade G. D., Bair E., et al. Pain sensitivity risk factors for chronic TMD: descriptive data and empirically identified domains from the OPPERA case control study. The Journal of Pain. 2011;12(11):T61–T74. doi: 10.1016/j.jpain.2011.08.006.
    1. Armijo-Olivo S., Fuentes J., Major P. W., Warren S., Thie N. M. R., Magee D. J. The association between neck disability and jaw disability. Journal of Oral Rehabilitation. 2010;37(9):670–679. doi: 10.1111/j.1365-2842.2010.02098.x.
    1. Visscher C. M., Lobbezoo F., Naeije M. Comparison of algometry and palpation in the recognition of temporomandibular disorder pain complaints. Journal of Orofacial Pain. 2004;18(3):214–219.
    1. Farella M., Michelotti A., Steenks M. H., Romeo R., Cimino R., Bosman F. The diagnostic value of pressure algometry in myofascial pain of the jaw muscles. Journal of Oral Rehabilitation. 2000;27(1):9–14. doi: 10.1046/j.1365-2842.2000.00526.x.
    1. Silva R. S. S., Conti P. C., Lauris J. R., da Silva R. O., Pegoraro L. F. Pressure pain threshold in the detection of masticatory myofascial pain: an algometer-based study. Journal of Orofacial Pain. 2005;19(4):318–324.
    1. Okeson J. P. Bell's Orofacial Pains: The Clinical Management of Orofacial Pain. 6th. Surrey, Canada: Quintessence Books; 2005.
    1. Bernhardt O., Schiffman E. L., Look J. O. Reliability and validity of a new fingertip-shaped pressure algometer for assessing pressure pain thresholds in the temporomandibular joint and masticatory muscles. Journal of Orofacial Pain. 2007;21(1):29–38.
    1. List T., Dworkin S. F. Comparing TMD diagnoses and clinical findings at Swedish and US TMD centers using research diagnostic criteria for temporomandibular disorders. Journal of Orofacial Pain. 1996;10(3):240–252.
    1. Ueda H. M., Kato M., Saifuddin M., Tabe H., Yamaguchi K., Tanne K. Differences in the fatigue of masticatory and neck muscles between male and female. Journal of Oral Rehabilitation. 2002;29(6):575–582. doi: 10.1046/j.1365-2842.2002.00869.x.
    1. Portney L. G., Watkins M. P. Foundations of Clinical Research Applications to Practice. 3rd. Upper Saddle River, NJ, USA: Pearson/Prentice Hall; 2009.
    1. Look J. O., John M. T., Tai F., et al. The research diagnostic criteria for temporomandibular disorders. II: reliability of Axis I diagnoses and selected clinical measures. Journal of Orofacial Pain. 2010;24(1):25–34.
    1. Cleland J. A., Childs J. D., Whitman J. M. Psychometric properties of the neck disability index and numeric pain rating scale in patients with mechanical neck pain. Archives of Physical Medicine and Rehabilitation. 2008;89(1):69–74. doi: 10.1016/j.apmr.2007.08.126.
    1. Sugisaki M., Kino K., Yoshida N., Ishikawa T., Amagasa T., Haketa T. Development of a new questionnaire to assess pain-related limitations of daily functions in Japanese patients with temporomandibular disorders. Community Dentistry and Oral Epidemiology. 2005;33(5):384–395. doi: 10.1111/j.1600-0528.2005.00238.x.
    1. Magee D. J. Orthopedic Physical Assessment. 4th. Philadelphia, Pa, USA: Saunders; 2002.
    1. Cook C., Richardson J. K., Braga L., et al. Cross-cultural adaptation and validation of the Brazilian Portuguese version of the neck disability index and neck pain and disability scale. Spine. 2006;31(14):1621–1627. doi: 10.1097/01.brs.0000221989.53069.16.
    1. Gay R. E., Madson T. J., Cieslak K. R. Comparison of the neck disability index and the neck bournemouth questionnaire in a sample of patients with chronic uncomplicated neck pain. Journal of Manipulative and Physiological Therapeutics. 2007;30(4):259–262. doi: 10.1016/j.jmpt.2007.03.009.
    1. McCarthy M. J. H., Grevitt M. P., Silcocks P., Hobbs G. The reliability of the Vernon and Mior neck disability index, and its validity compared with the short form-36 health survey questionnaire. European Spine Journal. 2007;16(12):2111–2117. doi: 10.1007/s00586-007-0503-y.
    1. Maixner W., Fillingim R., Sigurdsson A., Silva S. S. K. Sensitivity of patients with painful temporomandibular disorders to experimentally evoked pain: evidence for altered temporal summation of pain. Pain. 1998;76(1-2):71–81. doi: 10.1016/S0304-3959(98)00028-1.
    1. Mongini F., Ciccone G., Ceccarelli M., Baldi I., Ferrero L. Muscle tenderness in different types of facial pain and its relation to anxiety and depression: a cross-sectional study on 649 patients. Pain. 2007;131(1-2):106–111. doi: 10.1016/j.pain.2006.12.017.
    1. de Wijer A., Steenks M. H., Bosman F., Helders P. J. M., Faber J. Symptoms of the stomatognathic system in temporomandibular and cervical spine disorders. Journal of Oral Rehabilitation. 1996;23(11):733–741. doi: 10.1046/j.1365-2842.1996.00427.x.
    1. Etöz O. A., Ataoğlu H. Evaluation of pain perception in patients with temporomandibular disorders. Journal of Oral and Maxillofacial Surgery. 2007;65(12):2475–2478. doi: 10.1016/j.joms.2007.06.632.
    1. Sjölund B. H., Persson A. L. Pressure pain threshold changes after repeated mechano-nociceptive stimulation of the trapezius muscle: Possible influence of previous pain experience. Journal of Pain. 2007;8(4):355–362. doi: 10.1016/j.jpain.2006.11.003.
    1. Ylinen J., Nykänen M., Kautiainen H., Häkkinen A. Evaluation of repeatability of pressure algometry on the neck muscles for clinical use. Manual Therapy. 2007;12(2):192–197. doi: 10.1016/j.math.2006.06.010.
    1. Reid K. I., Gracely R. H., Dubner R. A. The influence of time, facial side, and location on pain-pressure thresholds in chronic myogenous temporomandibular disorder. Journal of Orofacial Pain. 1994;8(3):258–265.
    1. Gomes M. B., Guimarães J. P., Guimarães F. C., Neves A. C. C. Palpation and pressure pain threshold: Reliability and validity in patients with temporomandibular disorders. Cranio. 2008;26(3):202–210.
    1. Munro B. H. Statistical Methods for Health Care Research. Philadelphia, Pa, USA: Lippincott Williams & Wilkins; 2005.
    1. Herpich C. M., Sousa D. F. M., Vasconcelos T. M. O., et al. Head and neck posture evaluation in subjects with bruxism. Clinical and Experimental Medical Letters. 2013;54(1):83–86. doi: 10.12659/MST.889257.
    1. LeResche L. Epidemiology of temporomandibular disorders: implications for the investigation of etiologic factors. Critical Reviews in Oral Biology and Medicine. 1997;8(3):291–305. doi: 10.1177/10454411970080030401.
    1. Magnusson T., Egermark I., Carlsson G. E. A prospective investigation over two decades on signs and symptoms of temporomandibular disorders and associated variables. A final summary. Acta Odontologica Scandinavica. 2005;63(2):99–109. doi: 10.1080/00016350510019739.
    1. Huang G. J., LeResche L., Critchlow C. W., Martin M. D., Drangsholt M. T. Risk factors for diagnostic subgroups of painful Temporomandibular Disorders (TMD) Journal of Dental Research. 2002;81(4):284–288. doi: 10.1177/154405910208100412.
    1. Magnusson T., Egermark I., Carlsson G. E. A longitudinal epidemiologic study of signs and symptoms of temporomandibular disorders from 15 to 35 years of age. Journal of Orofacial Pain. 2000;14(4):310–319.
    1. Sherman J. J., LeResche L., Mancl L. A., Huggins K., Sage J. C., Dworkin S. F. Cyclic effects on experimental pain response in women with temporomandibular disorders. Journal of Orofacial Pain. 2005;19(2):133–143.
    1. de Leeuw R. Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management/The American Academy of Orofacial Pain. 4th. Chicago, Ill, USA: Quintessence Books; 2008.
    1. Younger J. W., Shen Y. F., Goddard G., Mackey S. C. Chronic myofascial temporomandibular pain is associated with neural abnormalities in the trigeminal and limbic systems. Pain. 2010;149(2):222–228. doi: 10.1016/j.pain.2010.01.006.
    1. Rantala M. A. I., Ahlberg J., Suvinen T. I., et al. Temporomandibular joint related painless symptoms, orofacial pain, neck pain, headache, and psychosocial factors among non-patients. Acta Odontologica Scandinavica. 2003;61(4):217–222. doi: 10.1080/00016350310004089.
    1. Lobbezoo F., Visscher C. M., Naeije M. Impaired health status, sleep disorders, and pain in the craniomandibular and cervical spinal regions. European Journal of Pain. 2004;8(1):23–30. doi: 10.1016/S1090-3801(03)00061-2.
    1. Vedolin G. M., Lobato V. V., Conti P. C. R., Lauris J. R. P. The impact of stress and anxiety on the pressure pain threshold of myofascial pain patients. Journal of Oral Rehabilitation. 2009;36(5):313–321. doi: 10.1111/j.1365-2842.2008.01932.x.

Source: PubMed

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