Table 1.
Summary of included studies with assessment of treatment.
| Publication | Study Type | Age Inclusion Criteria: Male–Female Ratio, Age Range and Mean) |
Type of Treatment | Outcome | Conclusions |
|---|---|---|---|---|---|
| [16] | P |
n = 16 patients (M–F = 14:2 age range 21–40, mean age 26) Mean age 26 years 2 groups Control group investigated with no treatment n = 16 |
Counseling occlusal adjustment muscular exercises splint therapy |
From 9 symptomatic patients, 3 remained symptomatic | The masticatory muscles, head muscles, and TMDs are closely related. |
| [17] | P | 15 subjects (M–F = 8:7; Age range 20–41; Mean age 28.1) 2 groups: (1) natural dentition, muscle spasms in SCM and upper trapezius muscle (control); (2) same group after 1 h of splint therapy |
Full-arch maxillary stabilization occlusal splint |
Increase of the NSL-OPT angle Decrease of HOR/CVT, HOR/OPT, CVT/OPT Increase of distances D1 (C1–C6), D2 (C2–C6), D3 (C3–C6) |
significant extension of the head on the cervical spine decrease in cervical spine lordosis |
| [21] | P |
n = 22 female patients with TMDs Lordosis <20° muscle pain history for at least six months, and with an intensity >6 Patients had to present the angle formed by the posterior tangents to C2 and C7 of equal or less than 20° |
six months of continuous MAA use | a significant increase in the cervical lordosis | homeostasis of the craniocervical system |
| [18] | R |
n = 187 4 groups: (1) no TMD, n = 45; (2) painful TMD, n = 52; (3) painful TMD and then migraine, n = 47; (4) migraine and then painful TMD n = 43 |
Stabilization splint Physical therapy For 6 months |
(4) improved less in orofacial, neck, and forward head posture after 6 months of TMD treatment than (2) and (3). After 6 months of TMD treatment, (4) had less migraine intensity, duration, and frequency than TMD1ST. | The onset order of comorbid conditions relative to TMD could determine the effects of TMD management on migraine and cervical dysfunction symptoms. |
| [19] | R |
n = 114 M–F= 10:104 T0 T1 = 12 months Presence of osteoarthritis (1) TMDnoOA n = 28 (2) TMJOApro n = 45 (3) TMJOAnopro n = 41 |
stabilization splint physical therapy |
In supine position, (2) had a larger oropharynx volume than (1), but there were no significant differences in the pharyngeal airway. T1 facial profiles (2) and (3) were more retrognathic than T0. (2) had a more forward head posture than (3) or (1). | TMJOApro may be related to upright head posture to compensate for reduced airway dimensions. |
| [20] | R | n = 43 TMD patients | Conservative therapy for 1 year | Before treatment, patients with cervical fusion (p = 0.019) or posterior arch deficiency (p = 0.004) had more neck muscle pain. After treatment, PAD patients had more mouth opening limitation (p = 0.028) and masticatory muscle pain (p = 0.014) than patients without the deficiency. | Upper cervical spine characteristics affect TMD treatment outcomes. |
TMDs––temporomandibular joint disorders; HOR—true horizontal line; OPT—odontoid plane; TMJ—temporomandibular joint, OA—osteoarthritis; MAA—mandibular advancement appliance; P—prospective clinical trial; R—retrospective clinical trial; NSL/OPT—craniocervical angulation; HOR/CVT—true horizontal plane to cervical vertebrae tangent angle; HOR/OPT—odontoid process—true horizontal line angle; CVT/OPT—the cervical vertebrae—horizontal line angle; TMJOApro—progressive temporomandibular osteoarthritis; TMJOAnopro—no progressive temporomandibular osteoarthritis; TMDnoOA—without any pathologic bony changes in either side of the TMJ condyles.