Photographic metqhodaa
|
Braun6 – 1991 Postural differences between
asymptomatic men and women and craniofacial pain patients
Final Rating: WEAK Type of study: Cross-sectional
study |
N=49, unpaired Case Group: 9F Control Group: 40 (20F
e 20M) - Case Group F: 38.11 (SD=6.95)years -
Control Group: F: 28.4 (SD=9.29) years M: 29 (SD=4.39)
years - sample size calculation – not mentioned -
randomization to sample selection – not mentioned - Patients
with mixed TMD attended at an orofacial pain clinic |
- Photograph (sitting) + quantitative analysis - Forward
Head Position (FHP) - Reliability of measurement – not
mentioned - blinding of the examiner and previous training –
not mentioned |
Established criteria – not used |
Greater angular shoulder extension in the symptomatic group
Lower angle of FHP in the symptomatic group |
• WEAKNESSES: - postural assessment training – not
mentioned - blinding of the examiner - sample size
calculation – not mentioned - Established criteria to TMD
diagnosis – not mentioned • STRENGTHS: - suitable
statistics - procedures well described |
Hackney et al.11
- 1993 Relationship between forward head
posture and diagnosed internal derangement of the temporomandibular
joint Final Rating: WEAK Type of study:
Case-control |
N=44, paired - Case Group: 22 F: 19/M: 3
Mean age 38.6 years - Control Group: 22 F: 19/M:
3 Mean age 35.4 years - sample size calculation – not
mentioned - randomization to sample selection – not
mentioned - Paients with TMD arthrogenic – selected from a TMD
clinic |
- Photograph in sitting and standing posture - quantitative
analysis - Register and analysis performed by
the same examiner - Report previous examiner training
- blinding of the examiner – not mentioned - Report
consistency between – without use of suitable statistics |
Established criteria – not used Clinical examination
confirmed by MRI |
Without differences between groups |
• WEAKNESSES: - sample size is not justified -
examiners blinding – not mentioned - reliability – not
mentioned - Established diagnostic criteria – not used
• STRENGTHS: - paired sample - adequate
statistic - diagnosis confirmed by imaging |
Lee et al.50 - 1995 The relationship between
forward head posture and temporomandibular disorders. Final
Rating: WEAK Type of study: Case-control |
- N: 66, paired (age and gender) - Case Group: 33 F:
30/M: 3 Mean age: 31.4 (SD=10.1) years - Control
group: 33 F: 19 M: 3 Mean age: not
reported - sample size calculation – not mentioned -
randomization to sample selection – not mentioned - Patients
with mixed TMD selected from an orofacial pain center at the Kentucky
University |
- Craniocervical and shoulder photographs - reliability of
the measure and method – not mentioned - blinding of the
examiner – not mentioned
|
Established criteria – not used
|
- Forward Head Position angle lower in patient group -
Protrusion head higher in patients with TMD |
• WEAKNESSES: - calibration of raters – not
mentioned - method reliability – not mentioned -
examiners blinding – not mentioned - Established diagnostic
criteria – not used - sample size is not justified •
STRENGTHS: - paired grouvps - procedures well
described - adequate statistic - blinding of
patient |
Evcik and Aksoy12 - 2000 Correlation of TMJ
pathologies, neck pain and postural differences Final
Rating: WEAK Type of study: Case-control |
N: 38, unpaired. - Case Group: 18 F: 15 - 30.4 (7.6)
years M: 3 - 30.4 (8.7) years Mean age: 28.5
(SD=12.93) - Control Group: 20 F: 15 M:
5 Mean age: 29.7 (SD=9.76) - sample size calculation –
not mentioned - randomization to sample selection – not
mentioned - Patients with arthrogenous TMD |
- Posture photographs and quantitative analysis (lateral
photograph) - Information about the examiners (blinding,
training or reliability) – not mentioned |
- Established criteria – not mentioned TMD
detailed clinical examination + TMJ MRI |
Lower FHP angle in TMD Greater shoulder protrusion in
TMD
|
• WEAKNESSES: - unpaired sample - sample size is not
justified - examiners blinding – not mentioned -
reliability – not reported • STRENGTHS: - adequate
statistic - confirmation of diagnostic by imaging
|
Armijo-Olivo et al.21 - 2011 Head and cervical
posture in patients with temporomandibular disorders Final
Rating: STRONG Type of study: Cross-sectional
study |
N: 172 - Myogenous TMD Group: F/M: 55, mean age:
31.91 (SD=9.15) years - Mixed TMD Group: F/M: 49, mean
age: 30.88 (SD=8.19) years - Control Group: F/M: 50,
mean age: 28.28 (SD=7.26) years - Sample size
calculation - randomization of the selected sample was not
mentioned - Patients with myogenous and mixed TMD
selected from a orofacial pain clinic at the University of
Alberta |
- Lateral photographs of posture - Reliability of
measurement ICC: 0.99 - Training of examiner -
Blinding of the examiners |
- RDC/TMD |
- Difference for the eye-tragus-horizontal angle for myogenous TMD
patients compared to controls (i.e. greater head extension)
|
• WEAKNESSES: - randomization of the sample – not
mentioned - Validity of the method, not demonstrated •
STRENGTHS: - adequate statistic - sample size is
justified - procedures well described - reliability of
the measurements
|
Armijo-Olivo et al.19 - 2011 Clinical relevance
vs. statistical significance: Using neck outcomes in patients with
temporomandibular disorders as an example Final
Rating: STRONG Type of study: Cross-sectional
study |
N=154 - Case Group: with myogenous TMD - F/M:
56 with mixed TMD – F/M: 48 - Control Group: F/M:
50 - Sample size calculation - randomization of the
selected sample was not mentioned - Patients with myogenous
and mixed TMD selected from an orofacial pain clinic at the
University of Alberta |
- Lateral photographs of posture - Reliability of
measurement reported in a previous publication - Armijo-Olivo et
al.19 (2011) - Report of previous training
examiner - blinding of the examiners |
- RDC/TMD |
- Difference for the eye-tragus-horizontal angle in myogenous TMD
patients compared to controls – head extension - The effect
size was 0.48 (the authors consider a statistical difference, but not
clinical) |
• WEAKNESSES: - Randomization of the sample -
Validity of the method, but does not show it •
STRENGTHS: - sample size is justified - procedures
well described - reliability of the measurements -
adequate statistics |
Radiographic method
|
Sonnesen et al.10 - 2001 Temporomandibular
disorders in relation to craniofacial dimensions, head posture and
bite force in children selected for orthodontic treatment.
Final Rating: WEAK Type of study: Cross-sectional
study |
N: 96 children - 51 girls and 45 boys, between 7 and 13
years of age - sample size calculation – not mentioned
- randomization to sample selection – not mentioned - Patients
with mixed TMD - Children admitted for orthodontic treatment in a
dental service
|
- Postural assessment by radiography - Cephalometric
radiography - Excellent reliability of cephalometric tracings (ICC:
0.97 to 1.00) - blinding of the examiner – not
mentioned
|
- It did not use established criteria - Good
and excellent reliability assessment of TMD |
Low and moderate correlation (r: 0.21 to 0.37) between cervical
posture and craniocervical and pain on palpation of the masticatory
muscles, neck and shoulders - Head extension in TMD |
• WEAKNESSES: - Standardized criteria- not used -
sample size is not justified - examiners blinding – not
mentioned • STRENGTHS: - reliability and calibration
of raters - procedure well described |
D’Attilio et al.51 - 2004 Cervical lordosis angle
measured on lateral cephalograms; findings in skeletal class II female
subjects with and without TMD: a cross sectional study Final
Rating: MODERATE |
N=100; unpaired (but similar age range) - Case
Group: F: 50; mean age 28.6 (SD=3.3) years - Control
Group: F:50; mean age 29.3 (SD=3.2) years - sample
size calculation – not mentioned - randomization to sample
selection – not mentioned - Paients with TMD
arthrogenous (disk displacement with and without pain ) |
- Cephalometric radiography - SE2 = Σ
D2⁄ 2n (where, SE is the standard error, D is the
difference between duplicated measurements, and “n” is the number of
duplicated measurements) - Blinding of the examiner
|
- TMD: clinical assessment + MRI + X-ray - The same blinded
examiner |
Lower Cervical lordosis angle (CVT/EVT) – for TMD compared to
control group |
• WEAKNESSES: - sample size is not justified •
STRENGTHS: - TMD assessed by image - reliability and
error analysis - suitable statistics
|
Munhoz et al.13
- 2004 Radiographic evaluation of cervical
spine of subjects with temporomandibular joint internal
disorder Final Rating: WEAK Type of study:
Case-control |
N: 50
- Case Group: 30 F: 27 M: 3
Mean age: 22.9 (SD=5.3) years - Control Group: 20
F:14/M: 6 Mean age: 21.7 (SD=3.6) years - sample size
calculation – not mentioned - randomization to sample
selection – not mentioned - 3 blinded examiners -
Patients with arthrogenous and mixed TMD Selected from a TMD
clinic at the University of São Paulo |
- Radiographic posture analysis + quantitative and qualitative
analysis - Agreement between raters -
Viikari-Juntura56 method - Blinding of the
examiner
|
- TMD: interview + clinical assessment AAOP (to select) +
Helkimo57 - image analysis – not used
|
- There was not difference between groups |
• WEAKNESSES: - sample size is not justified -
unpaired sample • STRENGTHS: - adequate
statistics - blinded examiners - reliability -
TMD case definition = AAOP
|
Ioi et al.52 - 2008 Relationship of TMJ
osteoarthritis to head posture and dentofacial morphology
Final Rating: WEAK Type of study: Case-control |
N: 59, unpaired - Case Group: F: 34
(patients) mean age: 24.7 (SD=6.1) years - Control
Group: F: 25 (university and employees) mean age: 23.6
(SD=1.3) anos - Sample size calculation -
Randomization of the selected sample – not mentioned -
Patients with arthrogenous TMD |
- Radiographic posture analysis - Examiners were blinded –
not mentioned - Dahlberg error method: lower than 0.58 mm and
0.61 degrees Dahlberg method error: SE2=
SΣd2/2n (where, SE = Stantard error, d = difference
between repeated measurements and n = the number of records)
|
Muir and Goss58 arthrogenous TMD criteria (1990) -
Radiography |
- Craniocervical angles greater in TMD |
• WEAKNESSES: - unpaired sample - Examiners blinding
– not mentioned • STRENGTHS: - sample size is
justified - adequate statistic - Error analysis of
measurements - confirmation of diagnostic by imaging
|
Matheus et al.15 - 2009 The relationship between
temporomandibular dysfunction and head and cervical posture
Final Rating: WEAK Type of study: Cross-sectional
study |
N: 60 F: 47/M: 13 Mean age: 34.2 years Case
Group: 39 Control Group: 21 - sample size calculation
– not mentioned - randomization to sample selection – not
mentioned - Patients with arthrogeneous and mixed TMD |
- Cephalometric analysis of radiographic craniocervical
posture - measurement reproducibility - Blinding of
the examiner
|
- RDC/TMD + MRI examination - Experts and
blinded examiners to MRI
|
Disk displacement and neck posture – no association |
• WEAKNESSES: - sample size is not justified -
comparisons among small groups • STRENGTHS: -
procedures well described - experts and blinded
examiners - reproducibility of measurement - adequate
statistics - RDC/TMD used - confirmation of diagnostic
by imaging |
de Farias Neto et al.18 - 2010 Radiographic
measurement of the cervical spine in patients with temporomandibular
disorders Final Rating: WEAK Type of study:
Cross-sectional study |
N=56 - Case Group (12): M: 5, mean age 24 (SD=3.1)
years F: 7, mean age 21.4 (SD=4.4) years - Control
Group (11): M: 4, mean age 19 (SD=0.8) years F: 7,
mean age 20.6 (SD=3) years - sample size calculation – not
mentioned - randomization to sample selection – not
mentioned - Patients with mixed TMD Research subjects
in treatment at a clinic of orofacial pain |
- Lateral radiographs - reliability of the measures – not
mentioned - blinding of the examiner
|
- RDC/TMD |
- Differences in atlas plane angle from the horizontal and anterior
translation Greater flexion of the first cervical vertebra,
associated with cervical hyperlordosis in TMD |
• WEAKNESSES: - reliability measures – not mentioned
- small sample size - sample size calculation – not
mentioned
|
Photographic and radiographic method
|
Visscher et al.8 - 2002 Is there relationship
between head posture and craniomandibular pain? Final
Rating: WEAK Type of study: Cross-sectional study |
N=250 Case group: 138 However, only 130 were
subjected to postural analysis (8 patients had lost points in
radiographic analysis) TMD Group: 16 Cervical
dysfunction Group: 10 Mixed Group: 59 Control Group:
45 3 Cases Groups: Temporomandibular Disorders (TMD)
Group Cervical Spine Disorders (CSD) Group TMD and CSD
Group (both conditions together) - sample size calculation –
not mentioned - randomization to sample selection – not
mentioned - Patients with arthrogenous, myogenous and mixed
TMD consecutively selected from a dental clinic |
- Photography in sitting and standing + head/cervical X-ray
- Reliability of photographic method- ICC: 0.96 - Blinding of
the examiner - Experts, calibrated and blinded
examiners
|
- Established criteria – not used
|
No differences for head posture measurements between the groups |
• WEAKNESSES: - unpaired sample - standardized
criteria to diagnosis – not used - despite being large, the
sample was subdivided into 4 groups • STRENGTHS: -
adequate statistic - procedures well described -
experts examiners, calibrated and blinded – reliability reported |
Iunes et al.22 - 2009 Craniocervical postural
analysis in patients with TMD Final Rating:
WEAK Type of study: Case-control |
N= 90 women, paired - Group 1: F: 30 (myofascial
disorders ) mean age: 29.13 (SD=11.45) years - Group
2: F: 30 (mixed TMD) mean age: 28.13 (SD=9.42)
years - Control Group: F: 30 (asymptomatic)
mean age: 26.17 (SD=9.18) years - sample size calculation –
not mentioned - randomization to sample selection – not
mentioned - Patients with myogenous and mixed TMD |
- Radiography and photograph to perform posture analysis -
quantitative and qualitative analysis - Blinding of the
examiners - Reliability analysis of radiographic: ICC between
0.76 and 0.99 |
- RDC/TMD - Examiner training – not
mentioned |
- PHOTOGRAPH: no difference - RADIOGRAPH: no
difference - VISUAL ANALYSIS: no difference
|
• WEAKNESSES: - sample size is not justified, but
suitable • STRENGTHS: - case definition:
RDC/TMD - blinded and trained examiners - procedures
well described
|