IDENTIFICATION OF CORRELATION OF TEMPOROMANDIBULAR DYSFUNCTION AND CERVICAL SPINE DISORDERS

Abstract

Relevance. Temporomandibular dysfunction is associated with imbalance of the whole body in static and dynamic. Myofascial Pain in Temporomandibular joint often coexist with chronic neck pain, impacting on posture straightly by changing head position or indirectly by instability of muscles chains. Objective. This study aimed to evaluate frequency of cervical spine disorders (CSD) in case of Temporomandibular dysfunction (TMD), possible correlations between TMD and CSD  in frontal and lateral planes depends on ethiological factors. Materials and methods. The study included 208 patients. Study group consisted of 170 patients with TMD (female – 62,9 %, male – 37,1 %). Contol group consisted of 38 patients. Subjects were examined according to international clinical protocol RDC/TMD, NDI, masticatory,neck motor system were analysed by (BioPak EMG), position of condyles and bone structure – via computed tomography, position and disc reduction – via magnetic resonance imaging, occlusion – via TScan III, cephalometric analysis (frontal, lateral view), statistical analyses with program IBM SPSS Statistic Base v.22. Results. Female more often has temporomandibular dysfunction (62,9 %) than male (37,1 %) among the population. 47,05% were under 30 years. About 98,2 % of patients, presented complaining of Temporomandibular disorder symptoms had neck pain concomitantly and cervical spine disorders in different planes, 44,7% of patients without TMD, but with CSD, value at risk 2,2(95% VaR 1,54-3,13). Moreover 100% of those who did not report pain in the Temporomandibular joints, but presented only with clicking, had reported pain in the neck during physical examination. After examination patients were divided into 4 different clinical groups of TMD depends on ethiology-TMD-neck spinal disability. The largest is combined group – 67,67 % of total patients and is clinical manifested with TMD, spinal neck disorders in several planes. Different dysfunctional conditions between facial skull boned and cervical spine are closely interconnected with each other. Conclusions. There is positive, mild power of correlations between muscles groups trapezius-masseter, trapezius-temporalis (r=0,477, p<0,05), sternocleidomastoideus-temporalis (0,527, p<0,05), sternocleidomastoideus-masseter (0,575, p<0,05), which indicates cooperation between facial muscles and cervical spine muscles. There is changes in cervical spine depends on clinical group: lateral group – C type scoliosis, sagittal – from straightening of cervical lordosis to kyphosis, vertical – «wave» type of cervical spine, combined – combine of pathology in different planes. Initial form of lateral group TMD is characterized as myofascial pain syndrome with specific clinical symptoms, but without condyle and disc displacement, thus it can be as an early prophylactic stage and risk of disc subluxation.