Relationship between temporomandibular joint dysfunction and cervical inclination and craniocervical posture in class II division 1 malocclusion

Saba Sikandar; Naseer Chaudhry; Muhammad Imran Rahbar; Asim Riaz; Muhammad Mohsin Kamal; Usman Zaheer

Relationship between temporomandibular joint dysfunction and cervical inclination and craniocervical posture in class II division 1 malocclusion

Authors

Saba Sikandar BDS, FCPS, Senior Registrar, Orthodontic department, Fatima Memorial College of Dentistry, Lahore
Naseer Chaudhry BDS FCPS MCPS MCPS-HPE MPH. Professor Orthodontics. Fatima Memorial College of Dentistry, Lahore
Muhammad Imran Rahbar BDS FCPS. Professor Orthodontics. Fatima Memorial College of Dentistry, Lahore.
Asim Riaz BDS, FCPS. Assistant Professor Orthodontics. Fatima Memorial College of Dentistry, Lahore.
Muhammad Mohsin Kamal BDS, MPhil, Assistant Professor (Community Dentistry) FMH College of Medicine and Dentistry
Usman Zaheer BDS, FCPS. Associate Professor Orthodontics, Lahore Medical and Dental College, Lahore.

Keywords:

Class II division 1, craniocervical posture, malocclusion, temporomandibular dysfunction

Abstract

Introduction This study aimed to evaluate the relationship of Temporomandibular joint dysfunction (TMD) and different types of cervical spine inclination and craniocervical posture in a sample of Class II Division 1 malocclusion among adult Pakistani population.

Materials and Methods: Clinical examination of the joint with associated structures was performed to evaluate the Temporomandibular joint (TMJ) status. Lateral cephalograms carried out in natural head position were traced to classify the malocclusion through angles and evaluation of cervical inclination through two angles (OPT/HOR and CVT/HOR). Craniocervical posture was evaluated through two angles (NSL/OPT and NSL/CVT).

Results: Results of the study show that out of 70 adult Class II division 1 patients 65.7% had no TMD, 15.7% had moderate TMD and only 7.14% had severe TMD. Though TMD was found in all three types of craniocervical postures but the highest prevalence of TMD was found in the patients with extended craniocervical posture i.e., 55% with respect to angle NSL/CVT and 45% with respect to NSL/OPT. As per cervical inclination the prevalence of both moderate and severe TMD was highest in forward neck posture group. Moderate TMD was present in 45.5% - 72.7 % of the sample and severe TMD was present in 60% of forward neck posture group.

TMD was weakly but significantly correlated with craniocervical posture (r = 0.292, p = 0.014). There was no significant relationship of TMD with cervical inclination variables.

Conclusion: Results of this study conclude that high prevalence of TMD in the sample population with extended craniocervical posture and forward neck inclination. A weak correlation existed between the craniocervical posture and TMD. Extended craniocervical posture in the patients with skeletal and dental Class II Division 1 patients seems to be a risk factor for development of articular and functional problems.