04 February 2022

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Cervical pain in temporomandibular disorders: review study

Author: Massimo Ragonesi

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Over the years the mutual relationship between the various painful and limiting conditions of the craniofacial region has attracted attention of clinicians and researchers. Non-specific cervical pain (CP) has been considered a predisposing or perpetuating factor for temporomandibular disorders (TMD). The aim of the present study was to review the literature on the prevalence of CP in subjects with TMD. Secondary objective was to investigate the literature trend over the past twenty years in the number of publications on the specific topics covered by our review..

MATERIALS AND METHODS.
From the 524 articles identified by a defined search strategy, we selected ten relevant observational study and for each the following information were recorded: TMD sample size, demographic features (age and sex, when reported); methods for TMD and CP diagnosis, prevalence of CP. Then we measured odds, 95% confidence interval (95% CI) estimate for each CP prevalence and the statistical significance of the frequency distributions (p <0,05). A bibliometric analysis was also carried out on the trend of publications over the last twenty years.

RESULTS
The topic of our review has shown increasing interest in the literature of the last twenty years, with an increase in the number of publications over time (r = 0.88; P <0.05). Ten papers were included in the review (six studies from general population, three from patients and one from a mixed sample).   The percentage prevalence of CP was between 42.9% (95% CI: 24,5% 61,2%) and 88.2% (95% CI: 77,4% 99,1%), with odds ranging between 0.8 and 7.5. Specifically, among samples extracted from patient populations the prevalence of CP was between 47.3% and 73%. In six studies (6/10) a statistically significant prevalence of CP versus non-CP was recorded (P <0.05).

CONCLUSIONS
Scientific literature was oriented towards a specific neurophysiological relationship between TMD and CP, nevertheless the prevalence of CP was highly variable among the selected studies and ranged from 1/2 to 2/3 of patients with TMD. Absence of homogeneity between the studies considered and the limits of this work did not allow generalization of the results and meta-analysis of the data, but only a descriptive synthesis. In the future will be necessary to produce more information from both clinical experiences and scientific research to define more clearly the relationship between the different painful and limiting conditions of the craniofacial region.

CLINICAL SIGNIFICANCE
CP was a frequent phenomenon in the TMD clinical practice . Although definitive conclusions could not be produced, acquisition of CP knowledge and skills was suggested to dentists interested in TMD and orofacial pain management.