Head and cervical posture in patients with temporomandibular disorders.

AIM: To determine whether patients with myogenous or mixed (ie, myogeneous plus arthrogeneous) temporomandibular disorders (TMD) had different head and cervical posture measured through angles commonly used in clinical research settings when compared to healthy individuals. METHODS: One hundred fifty-four persons participated in this study. Of these, 50 subjects were healthy, 55 subjects had myogenous TMD, and 49 subjects had mixed TMD (ie, arthrogenous plus myogenous TMD). A lateral photograph was taken with the head in the self-balanced position. Four angles were measured in the photographs: (1) Eye-Tragus-Horizontal, (2) Tragus-C7-Horizontal, (3) Pogonion-Tragus-C7, and (4) Tragus-C7-Shoulder. Alcimagen software specially designed to measure angles was used in this study. All of the measurements were performed by a single trained rater, a dental specialist in orthodontics, blinded to each subject's group status. RESULTS: The only angle that reached statistical significance among groups was the Eye-Tragus-Horizontal (F = 3.03, P = .040). Pairwise comparisons determined that a mean difference of 3.3 degrees (95% confidence intervals [CI]: 0.15, 6.41) existed when comparing subjects with myogenous TMD and healthy subjects (P = .036). Postural angles were not significantly related to neck disability, jaw disability, or pain intensity. Intrarater and interrater reliability of the measurements were excellent, with intraclass correlation coefficient (ICC) values ranging between 0.996-0.998. CONCLUSION: The only statistically significant difference in craniocervical posture between patients with myogenous TMD and healthy subjects was for the Eye-Tragus-Horizontal angle, indicating a more extended position of the head. However, the difference was very small (3.3 degrees) and was judged not to be clinically significant.

Dental and skeletal changes during pressure garment use in facial burns: a systematic review.

OBJECTIVE: Concern exists regarding the combined effect of the burn itself in addition to the continuous use of the pressure garments on craniofacial structures. The purpose of this systematic review was to evaluate the available evidence regarding dental and skeletal changes produced during pressure garment use in facial burns. METHODS: Several electronic databases were screened for relevant articles and reference lists of pertinent articles were also hand-searched. RESULTS: Only a two-part study had the minimal set of criteria sought. They found that children with partial face burns had only a slightly reduced inferior growth of the mandible and an increase protrusion of anterior teeth, which stay unchanged even after discontinuation of the pressure garment. The group of children with total face burns showed changes in the direction of the growth of the mandible, from a normal anterior inferior direction to a more inferior direction, and in the maxillary horizontal growth. A trend of returning toward normality was found thereafter. CONCLUSIONS: There is scarcity of studies reporting dentomaxillofacial effects after pressure garment use in facial burns. The level of evidence presented in these articles does not give support to any strong conclusion regarding the craniofacial effects of facial burn management.