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      Static body postural misalignment in individuals with temporomandibular disorders: a systematic review

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          Abstract

          BACKGROUND:

          The association between body postural changes and temporomandibular disorders (TMD) has been widely discussed in the literature, however, there is little evidence to support this association.

          OBJECTIVES:

          The aim of the present study was to conduct a systematic review to assess the evidence concerning the association between static body postural misalignment and TMD.

          METHOD:

          A search was conducted in the PubMed/Medline, Embase, Lilacs, Scielo, Cochrane, and Scopus databases including studies published in English between 1950 and March 2012. Cross-sectional, cohort, case control, and survey studies that assessed body posture in TMD patients were selected. Two reviewers performed each step independently. A methodological checklist was used to evaluate the quality of the selected articles.

          RESULTS:

          Twenty studies were analyzed for their methodological quality. Only one study was classified as a moderate quality study and two were classified as strong quality studies. Among all studies considered, only 12 included craniocervical postural assessment, 2 included assessment of craniocervical and shoulder postures,, and 6 included global assessment of body posture.

          CONCLUSION:

          There is strong evidence of craniocervical postural changes in myogenous TMD, moderate evidence of cervical postural misalignment in arthrogenous TMD, and no evidence of absence of craniocervical postural misalignment in mixed TMD patients or of global body postural misalignment in patients with TMD. It is important to note the poor methodological quality of the studies, particularly those regarding global body postural misalignment in TMD patients.

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          Most cited references163

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          Review of aetiological concepts of temporomandibular pain disorders: towards a biopsychosocial model for integration of physical disorder factors with psychological and psychosocial illness impact factors.

          Several studies have reported that musculoskeletal disorders of the stomatognathic system, commonly known as temporomandibular disorders (TMD) resemble musculoskeletal disorders and chronic pain disorders in general. There is also general consensus that combined biomedical and biopsychosocial methods best support the assessment and management of the cardinal features of TMD, i.e., pain and dysfunction or physical (peripheral) and psychosocial (central) factors. This overview of the aetiology of TMD will outline conceptualizations of past models and present the current view that patients with TMD should be assessed according to both the physical disorder and the psychosocial illness impact factors. The conceptual theories outlined in this review include biomedical models related to temporomandibular joints, muscles of mastication and occlusal factors, psychological models and the biopsychosocial models. An integrated and multidimensional approach concerning physical and psychosocial factors in temporomandibular pain and dysfunction is presented as an example of how the biopsychosocial model and information processing theory may apply in the conceptualization and management of TMD for various health care professionals.
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            Studies on function and dysfunction of the masticatory system. II. Index for anamnestic and clinical dysfunction and occlusal state.

            M Helkimo (1974)
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              The Relationship Between the Stomatognathic System and Body Posture

              In recent years, many researchers have investigated the various factors that can influence body posture: mood states, anxiety, head and neck positions, oral functions (respiration, swallowing), oculomotor and visual systems, and the inner ear. Recent studies indicate a role for trigeminal afferents on body posture, but this has not yet been demonstrated conclusively. The present study aims to review the papers that have shown a relationship between the stomatognathic system and body posture. These studies suggest that tension in the stomatognathic system can contribute to impaired neural control of posture. Numerous anatomical connections between the stomatognathic system’s proprioceptive inputs and nervous structures are implicated in posture (cerebellum, vestibular and oculomotor nuclei, superior colliculus). If the proprioceptive information of the stomatognathic system is inaccurate, then head control and body position may be affected. In addition, the present review discusses the role the myofascial system plays in posture. If confirmed by further research, these considerations can improve our understanding and treatment of muscular-skeletal disorders that are associated with temporomandibular joint disorders, occlusal changes, and tooth loss.
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                Author and article information

                Journal
                Braz J Phys Ther
                Braz J Phys Ther
                rbfis
                Brazilian Journal of Physical Therapy
                Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia
                1413-3555
                1809-9246
                Nov-Dec 2014
                : 18
                : 6
                : 481-501
                Affiliations
                [1 ]Departamento de Neurosciências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
                [2 ]Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, FMRP, USP, Ribeirão Preto, SP, Brazil
                [3 ]Departamento de Medicina Social, FMRP, USP, Ribeirão Preto, SP, Brazil
                Author notes
                Correspondence Thaís Cristina Chaves Universidade de São Paulo Faculdade de Medicina de Ribeirão Preto Departamento de Neurosciências e Ciências do Comportamento Avenida dos Bandeirantes, 3900 CEP 14049-900, Ribeirão Preto, SP, Brasil e-mail: chavestc@ 123456fmrp.usp.br
                Article
                10.1590/bjpt-rbf.2014.0061
                4311593
                25590441
                dcb37cbc-dc9c-4182-8655-3159a4db253e

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 October 2013
                : 16 April 2014
                : 04 June 2014
                Page count
                Figures: 1, Tables: 4, References: 59
                Categories
                Systematic Review

                temporomandibular disorders,body posture,craniocervical posture,systematic review

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