{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T19:08:14Z","timestamp":1788894494519,"version":"build-2803163510"},"reference-count":36,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T00:00:00Z","timestamp":1653091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The aim of the study was to assess the craniovertebral and craniomandibular changes in patients diagnosed with temporomandibular joint disorders (TMD) after physiotherapy combined with occlusal splint therapy. Materials and Methods: There were forty patients (32 females, 80%), diagnosed with TMD, included into the study group. After the initial series of physiotherapy, patients received maxillary occlusal splints to be worn day and night. Participants continued physiotherapy simultaneously with occlusal splint therapy for 6 months. Lateral cephalograms taken in natural head position before and after the end of the therapy were used for measurements. The control group consisted of 15 healthy participants (12 females, 80%), who had taken lateral cephalograms twice, and did not receive any type of occlusal treatment nor physiotherapy in the meantime. Results: Occlusal splint therapy and physiotherapy combined together significantly affected: the vertical position of the mandible (significant increase, p &lt; 0.0001), the sagittal position of mandible (significant decrease, p = 0.0065), as well as the width of the functional space between C1 and C2 (significant decrease, p = 0.0042). Moreover, the cervical lordosis was restored after the end of the treatment (p &lt; 0.0001). Conclusions: Cooperation of physiotherapists with dental practitioners is necessary in the treatment of patients with TMD, including temporomandibular joint osteoarthritis.<\/jats:p>","DOI":"10.3390\/medicina58050684","type":"journal-article","created":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T09:18:08Z","timestamp":1653124688000},"page":"684","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Craniovertebral and Craniomandibular Changes in Patients with Temporomandibular Joint Disorders after Physiotherapy Combined with Occlusal Splint Therapy: A Prospective Case Control Study"],"prefix":"10.3390","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7203-271X","authenticated-orcid":false,"given":"Marcin","family":"Derwich","sequence":"first","affiliation":[{"name":"ORTODENT, Specialist Orthodontic Private Practice in Grudziadz, 86-300 Grudziadz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Gottesman","sequence":"additional","affiliation":[{"name":"Independent Researcher, New York, NY 11570, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolina","family":"Urbanska","sequence":"additional","affiliation":[{"name":"Independent Researcher, 87-100 Torun, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5373-4783","authenticated-orcid":false,"given":"Elzbieta","family":"Pawlowska","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.11607\/jop.1151","article-title":"International RDC\/TMD Consortium Network, International association for Dental Research; Orofacial Pain Special Interest Group, International Association for the Study of Pain. Diagnostic Criteria for Temporomandibular Disorders (DC\/TMD) for Clinical and Research Applications: Recommendations of the International RDC\/TMD Consortium Network and Orofacial Pain Special Interest Group","volume":"28","author":"Schiffman","year":"2014","journal-title":"J. Oral Facial. Pain Headache"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1111\/joor.12378","article-title":"Next steps in development of the diagnostic criteria for temporomandibular disorders (DC\/TMD): Recommendations from the International RDC\/TMD Consortium Network workshop","volume":"43","author":"Michelotti","year":"2016","journal-title":"J. Oral Rehabil."},{"key":"ref_3","first-page":"378","article-title":"Diagnosis and treatment of temporomandibular disorders","volume":"91","author":"Gauer","year":"2015","journal-title":"Am. Fam. Physician"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.cden.2013.04.006","article-title":"Epidemiology, diagnosis, and treatment of temporomandibular disorders","volume":"57","author":"Liu","year":"2013","journal-title":"Dent. Clin. N. Am."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1007\/s00784-020-03710-w","article-title":"Prevalence of temporomandibular joint disorders: A systematic review and meta-analysis","volume":"25","author":"Valesan","year":"2021","journal-title":"Clin. Oral Investig."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s10266-019-00439-1","article-title":"Estrogen signaling impacts temporomandibular joint and periodontal disease pathology","volume":"108","author":"Robinson","year":"2020","journal-title":"Odontology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/j.tripleo.2011.04.021","article-title":"Research diagnostic criteria for temporomandibular disorders: A systematic review of axis I epidemiologic findings","volume":"112","author":"Manfredini","year":"2011","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endodontol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1111\/joor.12531","article-title":"Temporomandibular disorders and dental occlusion. A systematic review of association studies: End of an era?","volume":"44","author":"Manfredini","year":"2017","journal-title":"J. Oral Rehabil."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1080\/00016350510019739","article-title":"A prospective investigation over two decades on signs and symptoms of temporomandibular disorders and associated variables. A final summary","volume":"63","author":"Magnusson","year":"2005","journal-title":"Acta Odontol. Scand."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1111\/j.1365-2842.2010.02087.x","article-title":"The role of orthodontics in temporomandibular disorders","volume":"37","author":"Michelotti","year":"2010","journal-title":"J. Oral Rehabil."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Derwich, M., Mitus-Kenig, M., and Pawlowska, E. (2020). Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis-Review of the Literature. Medicina, 56.","DOI":"10.3390\/medicina56050225"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.math.2008.09.001","article-title":"The mechanisms of manual therapy in the treatment of musculoskeletal pain: A comprehensive model","volume":"14","author":"Bialosky","year":"2009","journal-title":"Man. Ther."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.jmpt.2013.12.007","article-title":"Effects of massage therapy and occlusal splint therapy on mandibular range of motion in individuals with temporomandibular disorder: A randomized clinical trial","volume":"37","author":"Gomes","year":"2014","journal-title":"J. Manip. Physiol. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Kuzmanovic Pficer, J., Dodic, S., Lazic, V., Trajkovic, G., Milic, N., and Milicic, B. (2017). Occlusal stabilization splint for patients with temporomandibular disorders: Meta-analysis of short and long term effects. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0171296"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1111\/joor.12321","article-title":"Manual therapy for the management of pain and limited range of motion in subjects with signs and symptoms of temporomandibular disorder: A systematic review of randomised controlled trials","volume":"42","author":"Calixtre","year":"2015","journal-title":"J. Oral Rehabil."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"E2","DOI":"10.3171\/2015.1.FOCUS14807","article-title":"Anatomy and biomechanics of the craniovertebral junction","volume":"38","author":"Lopez","year":"2015","journal-title":"Neurosurg. Focus"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1002\/ar.23943","article-title":"Masticatory Muscles and Branches of Mandibular Nerve: Positional Relationships Between Various Muscle Bundles and Their Innervating Branches","volume":"302","author":"Akita","year":"2019","journal-title":"Anat. Rec."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2808","DOI":"10.1044\/2017_JSLHR-S-16-0277","article-title":"Architecture of the Suprahyoid Muscles: A Volumetric Musculoaponeurotic Analysis","volume":"60","author":"Shaw","year":"2017","journal-title":"J. Speech Lang. Hear. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1007\/s00455-006-9063-2","article-title":"Morphologic characteristics of the superior pharyngeal constrictor muscle in relation to the function during swallowing","volume":"22","author":"Tsumori","year":"2007","journal-title":"Dysphagia"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Derwich, M., and Pawlowska, E. (2022). Do the Mandibular Condyles Change Their Positions within Glenoid Fossae after Occlusal Splint Therapy Combined with Physiotherapy in Patients Diagnosed with Temporomandibular Joint Disorders? A Prospective Case Control Study. J. Pers. Med., 12.","DOI":"10.3390\/jpm12020254"},{"key":"ref_21","unstructured":"Rocabado, M., and Iglarsh, Z.A. (1991). Physical modalities and manual techniques used in the treatment of maxillofacial pain. Musculoskeletal Approach to Maxillofacial Pain, JB Lippincott. [1st ed.]."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Derwich, M., Mitus-Kenig, M., and Pawlowska, E. (2021). Is the Temporomandibular Joints' Reciprocal Clicking Related to the Morphology and Position of the Mandible, as Well as to the Sagittal Position of Lower Incisors?-A Case-Control Study. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18094994"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1080\/07345410.1983.11677834","article-title":"Biomechanical relationship of the cranial, cervical, and hyoid regions","volume":"1","author":"Rocabado","year":"1983","journal-title":"J. Craniomandib. Pract."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1186\/s10194-015-0586-5","article-title":"Reported concepts for the treatment modalities and pain management of temporomandibular disorders","volume":"16","author":"Wieckiewicz","year":"2015","journal-title":"J. Headache Pain."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1111\/j.1365-2842.2007.01748.x","article-title":"Short-term efficacy of physical therapy compared to splint therapy in treatment of arthrogenous TMD","volume":"34","author":"Ismail","year":"2007","journal-title":"J. Oral Rehabil."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"6122","DOI":"10.21037\/apm-21-451","article-title":"Effectiveness of exercise therapy versus occlusal splint therapy for the treatment of painful temporomandibular disorders: A systematic review and meta-analysis","volume":"10","author":"Zhang","year":"2021","journal-title":"Ann. Palliat. Med."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Esp\u00ed-L\u00f3pez, G.V., Arnal-G\u00f3mez, A., Cuerda Del Pino, A., Benavent-Corai, J., Serra-A\u00f1\u00f3, P., and Ingl\u00e9s, M. (2020). Effect of Manual Therapy and Splint Therapy in People with Temporomandibular Disorders: A Preliminary Study. J. Clin. Med., 9.","DOI":"10.3390\/jcm9082411"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1179\/crn.2010.007","article-title":"Anterior throat pain syndromes: Causes for undiagnosed craniofacial pain","volume":"28","author":"Shankland","year":"2010","journal-title":"Cranio"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1080\/08869634.1994.11677993","article-title":"Influence of stabilization occlusal splint on craniocervical relationships. Part I: Cephalometric analysis","volume":"12","author":"Moya","year":"1994","journal-title":"Cranio"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1080\/08869634.1997.11746015","article-title":"Increase of the vertical occlusal dimension by means of a removable orthodontic appliance and its effect on craniocervical relationships and position of the cervical spine in children","volume":"15","author":"Miralles","year":"1997","journal-title":"Cranio"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1002\/cre2.136","article-title":"Effect of occlusal splint and therapeutic exercises on postural balance of patients with signs and symptoms of temporomandibular disorder","volume":"5","author":"Oliveira","year":"2019","journal-title":"Clin. Exp. Dent. Res."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Headache Classification Committee of the International Headache Society (IHS) (2013). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia, 33, 629\u2013808.","DOI":"10.1177\/0333102413485658"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1007\/s11910-019-0937-8","article-title":"Occipital Neuralgia and Cervicogenic Headache: Diagnosis and Management","volume":"19","author":"Barmherzig","year":"2019","journal-title":"Curr. Neurol. Neurosci. Rep."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1007\/s11916-001-0029-7","article-title":"Cervicogenic headache: Anatomic basis and pathophysiologic mechanisms","volume":"5","author":"Bogduk","year":"2001","journal-title":"Curr. Pain. Headache Rep."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1080\/08869634.1987.11678183","article-title":"The importance of soft tissue mechanics in stability and instability of the cervical spine: A functional diagnosis for treatment planning","volume":"5","author":"Rocabado","year":"1987","journal-title":"Cranio"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1016\/j.spinee.2017.02.007","article-title":"Cervical lordosis: The effect of age and gender","volume":"17","author":"Been","year":"2017","journal-title":"Spine J."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/5\/684\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:16:08Z","timestamp":1760138168000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/5\/684"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,21]]},"references-count":36,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["medicina58050684"],"URL":"https:\/\/doi.org\/10.3390\/medicina58050684","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,21]]}}}