Correlation Between Craniovertebral Angle and Temporomandibular Disorders

NCT07522749 | Completed

• 1 other identifier: P.T.REC/012/006376
• Study Type: observational
• Target: 68
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of study was investigate the correlation between craniovertebral angle and Temporomandibular disorders.

Conditions

Temporomandibular Joint Disorders

Outcome Measures

Primary Outcomes (4)

• Craniovertebral Angle (CVA) assessment

  The CVA was measured using digital image analysis of a lateral- view photograph of each participant seated in the same standard chair. Participants were instructed to adopt a relaxed posture, ensuring that the thoracic and lumbar regions contact the backrest, their gaze was directed toward the horizon, and both feet rest flat on the floor with knees flexed at 90°. A camera was positioned one meter from the participant on a level tripod at shoulder height. A marker was affixed with adhesive tape at the level of the C7 vertebra, ensuring that the participant's ear tragus remains visible within the photo frame. Identification of the C7 vertebra was conducted using active cervical rotation as described elsewhere. The image was analyzed using Kinovea 0.8.15 software, defining the craniovertebral angle as the angle formed between a horizontal line and the line connecting the spinous process of C7 to the ear's tragus. FHP is defined as CVA \<50°.

  8 weeks

• Fonseca questionnaire for temporomandibular disorders (TMDs) assessment

  The Arabic version of Fonseca's questionnaire was used for screening temporomandibular disorders (TMDs). The questionnaire consists of 10 questions, each question having a three-point scale. For each question, the participants were instructed that only one answer was marked: "yes" (10 points), "no" (0 points), and "maybe" (5 points). Based on the sum of their points, the individuals were classified as the TMD- free (0-15), mild TMD (20-40), moderate TMD (45-60), and severe TMD (70-100).

  8 weeks

• Temporomandibular joint opening

  The TheraBite Jaw Motion Rehabilitation System was used to assess temporomandibular opening range. The participant was asked to open their mouth as wide as possible. The TheraBite scale was placed between the central incisors to measure the maximum vertical distance during active mouth opening. The scale is a disposable paper measurement tool used to assess maximum mouth opening (MMO) in millimeters (mm)

  8 weeks

• Temporomandibular joint lateral excursions

  The TheraBite Jaw Motion Rehabilitation System was used to assess temporomandibular-lateral excursion range. The participant will be seated with a neutral head position. Initially, the examiner will align the scale's reference mark with the midline of the upper central incisors. Next, the participant will be instructed to move their mandible laterally; first to the right and then to the left, as far as comfortably possible without inducing pain. The lateral excursion will then be quantified by measuring the horizontal distance (in millimeters) between the upper midline and the new position of the lower incisor midline.

  8 weeks

Study Arms (1)

Forward head posture group

Sixty-eight male and female participants aged between 18 and 40 years. All participants demonstrated measurable FHP, defined as a CVA of less than 50°, assessed using Kinovea software.

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Sixty-eight male and female participants aged between 18 and 40 years. All participants demonstrated measurable forward head posture, defined as a craniovertebral angle less than 50°, assessed using Kinovea software.

You may qualify if:

• Male and female with body mass index (18.5-29.9 kg/m2).
• Chronic temporomandibular joint dysfunction symptoms persisting for at least 3 months, with a cut-off point score of the Fonseca's Anamnestic Index of 20 points or more
• Craniovertebral angle (CVA) of less than 50°.
• Participants must exhibit measurable FHP, defined as a craniovertebral angle (CVA) \<50°, assessed using Kinovea software.
• Participant has mouth opening less than 40mm.
• Participants haven't received any physiotherapy sessions on cervical or temporomandibular joint in last 6 weeks, nor have taken any non- steroidal anti-inflammatory drugs (NSAIDs) for the last two weeks preceding the study.

You may not qualify if:

• History of acute head, neck, or Temporomandibular joint trauma or any surgical intervention in these regions within the past 6 months.
• Congenital temporomandibular joint abnormalities.
• Participants with congenital deformities of the head and the neck.
• Participants with systemic diseases, such as rheumatoid arthritis.
• Participants received physical therapy or other conservative treatments for neck pain, temporomandibular disorders, or postural correction within the past 3 months.
• Major psychiatric disorders.

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Mohamed Mahmoud Mousa

Cairo, Egypt

Location

MeSH Terms

Conditions

Temporomandibular Joint Disorders

Condition Hierarchy (Ancestors)

Craniomandibular Disorders; Mandibular Diseases; Jaw Diseases; Musculoskeletal Diseases; Joint Diseases; Muscular Diseases; Stomatognathic Diseases

Study Officials

• Hussein Khalil

  Sinai University

  STUDY DIRECTOR

• Nasr Abdelkader, Professor

  Cairo University

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Study Record Dates

• First Submitted: April 4, 2026
• First Posted: April 13, 2026
• Study Start: November 1, 2025
• Primary Completion: January 20, 2026
• Study Completion: January 30, 2026
• Last Updated: April 13, 2026

Record last verified: 2026-04

Locations

EG (1)