Body posture photographs as a diagnostic aid for musculoskeletal disorders related to temporomandibular disorders (TMD)

The purpose of this study was to test the hypothesis that body posture could be an etiologic factor in patients with temporomandibular disorders. "Faulty" body posture has been considered to be an initiating and perpetuating etiologic factor in some temporomandibular disorders (TMD). Although in patients with temporomandibular disorders a significant craniocervical dysfunction has been established, a causal relationship between posture and TMD has not yet been proved. Two samples of 40 subjects each were selected, age and gender matched. The experimental group consisted of 40 patients, who were not previously treated for temporomandibular dysfunction. TMD of these patients was diagnosed on the basis of a questionnaire and a thorough intra- and extraoral examination. The clinical symptoms of TMD were confirmed with transcranial x-rays and the condylar tracings of the performed axiography. A clinical examination was done to confirm the good health of the control group. In addition, symptoms of craniocervical dysfunction within the experimental group were evaluated to make a proper referral to a physical therapist, Four photographs of the orthostatic posture were taken. In accordance with anthropometric guidelines, the following anatomical landmarks were palpated and applied on the skin with a dark lipstick on forehand: both acromiones of the scapula and the anterior (ASIS) and posterior superior iliac spine (PSIS). Statistical testing was performed to confirm the data fit a normal distribution. The differences between the experimental group and the control group were tested with Student's two sample T-test. Within the experimental group, a significant correlation existed between the shoulder line and the pelvis line, on the frontal as well as on the dorsal photograph. The results suggest a somatic basis for the observed postural imbalances in patients with temporomandibular disorders. The results, however, must be interpreted with reservation.