Temporomandibular disorders and cervical spine: a systematic review

Aims: Temporomandibular disorders (TMD) are a wide group of clinical conditions affecting the temporomandibular joint and the surrounding neuronal and musculoskeletal components. Cervical spine pain (CSP) has been proposed as a risk factor. Thus, the aim of this review is to analyse the available literature to document anatomical, pain and postural association between TMD and cervical spine. Methods: A systematic review of the literature was performed on TMD and cervical spine, using the following inclusion criteria: studies of any level of evidence, reporting clinical or preclinical results and dealing with the anatomical, pain and postural association between TMD and cervical spine. Results: A total of n=1150 articles was found. After duplicates exclusion, n=947 articles were selected. At the end of the first screening, following the previously described selection criteria, we selected n=55 articles eligible for full-text reading. Ultimately, after full-text reading, and reference list check, we selected n=25 articles following previously written criteria. Conclusions: The literature available on the association between TMD and CSP presents major limitations in terms of great heterogeneity. Although a lot of studies focused on the genetic, biomechanical, and radiological background of the disease there is lack of consensus on one or multiple major actors. However, based on our analysis an association between TMD and cervical pain-related symptoms (headache, cervical pain, back pain) can be assumed. More studies are needed to understand the complex and multifactorial genesis of the association.