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The hypothesis of a functional coupling between the muscles of the craniomandibular system and the muscles of other body areas is still controversial. The purpose of this pilot study was to examine whether there is a relationship between the craniomandibular system, the craniocervical system and the sacropelvic region. To test this hypothesis, the prevalence and localization of dysfunction of the cervical spine and the sacroiliac joint were examined in a prospective, experimental trial. Twenty healthy students underwent an artificial occlusal interference, which caused an occlusal interference. The upper cervical spine (CO-C3) and the sacroiliac joint were examined before, during and after this experimental test. The primary outcome with these experimental conditions was the occurrence of hypomobile functional abnormalities. In the presence of occlusal interference, functional abnormalities were detected in both regions examined and these changes were statistically significant. The clinical implications of these findings may be that a complementary examination of these areas in CMD patients could be useful.

Patients with temporomandibular disorders (TMDs) frequently show symptoms related to the cervical spine. It is however unknown whether patients with TMD who have no symptoms in the neck region often have signs of cervical spine dysfunction (CSD) and whether there is a predominant localization of these asymptomatic CSDs. In a prospective and controlled examiner-blinded clinical trial, the prevalence and localization of asymptomatic CSD in patients with TMD was examined. Thirty patients with internal derangement of the temporomandibular joint but without any neck problems were compared with 30 age and gender matched healthy controls. Significantly more asymptomatic dysfunctions of the vertebral joints and increased muscle tenderness were found in the patient group. The difference between patents and nonpatients for vertebral joint dysfunction and muscle tenderness was greatest in the upper cervical spine. These findings support the thesis that a complementary examination of this area should be performed, even when TMD patents do not report any neck problems.

The objective of this study was to determine the influence of medical and physical therapy on long-term treatment outcome in 72 patients with anterior disk displacement without reduction. Patients were treated solely with occlusal splints (group I), with splints and supplementary medical therapy (group II), with splints and physical therapy (group III) or with splints, medical, and physical therapy (group IV). After therapy, the maintenance of improvement was objectively and subjectively assessed with an extensive clinical examination and a postal questionnaire. The percentage of pain free patients after therapy was 76% in group I, 88% in group II, 43% in group III, and 65% in group IV. There was a statistically significant higher increase of maximum jaw opening after therapy in group II than in the control groups (p<0.05). The improvement in mouth opening came to 9.7 mm in group I, 14.5 mm in group II, 7.3 mm in group III, and 11.2 mm in group IV. Medical therapy seems to have a positive influence on the treatment outcome of patients with anterior disk displacement without reduction.