Temporomandibular Joint DisordersNCT07522749
Correlation Between Craniovertebral Angle and Temporomandibular Disorders
An observational study of Temporomandibular Joint Disorders, run by Cairo University at 1 site in Egypt.
Trial summary
The purpose of study was investigate the correlation between craniovertebral angle and Temporomandibular disorders. Read more about this study
- Who is it for?
- Ages 18 to 40 years
- Conditions the study is for
- Temporomandibular Joint Disorders
- How many people
- 68 participants
- Where
- 1 siteEgypt
- Study dates
- 1 Nov 2025to 30 Jan 2026
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 40 years
- All sexes
- No healthy volunteers
- Adult
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.
Who may be able to join
- 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.
Who cannot join
- The subjects were excluded if they were unable to fulfil the inclusion criteria and if they had a history of any of the following:
- 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.
Trial locations and contacts
1 site in 1 country.
About this study
The purpose of study was investigate the correlation between craniovertebral angle and Temporomandibular disorders.
Read the detailed description
Individuals with forward head posture (FHP) were three times more likely to develop temporomandibular disorder (TMD) compared to those with normal posture. It was discovered that improper head and cervical position was present in almost 70% of TMD participants. Participants with TMD were especially likely to have a forward-leaning head posture. Recommended postural testing as part of TMD evaluation, implying that postural disorders may cause or worsen TMD symptoms FHP is characterized as the cervical spine held in a protracted position for a prolonged duration; it can lead to alterations in head posture, ultimately leading to poor posture, which is thought to be a deviation from neutral or normal posture.
There is evidence from certain studies that people with TMDs have altered head and cervical spine posture, while no such link is found in other investigations. The skull, mandible, and cervical spine exhibit neurological and biomechanical connections, generating a functional complex that may be referred to as the "Cranio Cervical Mandibular system," which is related to the cervical area via muscles and ligaments.
TMD symptoms and cervical dysfunction are strongly correlated, supporting combined evaluation, and this will significantly aid in the treatment of participants with temporomandibular joint dysfunction and forward head posture.
- Conditions
- Temporomandibular Joint Disorders
- Medical subject headings
- Temporomandibular Joint Disorders
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Other
| Study group | Role | What they receive |
|---|---|---|
| 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. |
What is being measured
The primary outcome is the main question the study is designed to answer.
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°.
Measured: 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).
Measured: 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)
Measured: 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.
Measured: 8 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Apr 2026
- Study start1 Nov 2025
- Primary completion20 Jan 2026
- Study completion30 Jan 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Temporomandibular Joint DisordersStudies of the same condition, open and under way.
- More trials run by Cairo UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Other
- Time perspective
- Cross-sectional
- Enrolment
- 68 participants (actual)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Mohamed Mahmoud Mousa, Cairo University
- Investigators
- Hussein Khalil, Study director, Sinai UniversityNasr Abdelkader, Professor, Study chair, Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07522749
- Sponsor's protocol ID
- P.T.REC/012/006376
- Status last verified
- Apr 2026
- First submitted
- 4 Apr 2026
- Last updated
- 13 Apr 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 13 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Correlation Between Craniovertebral Angle and Temporomandibular Disorders
- ClinicalTrials.gov ID
- NCT07522749
- Acronym / sponsor ID
- P.T.REC/012/006376
- Conditions
- Temporomandibular Joint Disorders
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 68 participants (actual)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 1 Nov 2025 (actual)
- Primary completion
- 20 Jan 2026 (actual)
- Study completion
- 30 Jan 2026 (actual)
- First posted
- 13 Apr 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of study was investigate the correlation between craniovertebral angle and Temporomandibular disorders.
Detailed description
Individuals with forward head posture (FHP) were three times more likely to develop temporomandibular disorder (TMD) compared to those with normal posture. It was discovered that improper head and cervical position was present in almost 70% of TMD participants. Participants with TMD were especially likely to have a forward-leaning head posture. Recommended postural testing as part of TMD evaluation, implying that postural disorders may cause or worsen TMD symptoms FHP is characterized as the cervical spine held in a protracted position for a prolonged duration; it can lead to alterations in head posture, ultimately leading to poor posture, which is thought to be a deviation from neutral or normal posture.
There is evidence from certain studies that people with TMDs have altered head and cervical spine posture, while no such link is found in other investigations. The skull, mandible, and cervical spine exhibit neurological and biomechanical connections, generating a functional complex that may be referred to as the "Cranio Cervical Mandibular system," which is related to the cervical area via muscles and ligaments.
TMD symptoms and cervical dysfunction are strongly correlated, supporting combined evaluation, and this will significantly aid in the treatment of participants with temporomandibular joint dysfunction and forward head posture.
Study design
- Observational model
- Other
- Time perspective
- Cross-sectional
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| 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. |
Who may qualify
- Ages
- 18 to 40 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
- 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.
Key inclusion criteria (6 listed)
- 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.
Key exclusion criteria (7 listed)
- The subjects were excluded if they were unable to fulfil the inclusion criteria and if they had a history of any of the following:
- 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.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Other | Forward head posture group |
Primary outcome
Craniovertebral Angle (CVA) assessment
Time frame: 8 weeks
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°.
Fonseca questionnaire for temporomandibular disorders (TMDs) assessment
Time frame: 8 weeks
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).
Temporomandibular joint opening
Time frame: 8 weeks
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)
Temporomandibular joint lateral excursions
Time frame: 8 weeks
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.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Apr 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Hussein Khalil study director
Sinai University
Nasr Abdelkader, Professor study chair
Cairo University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Temporomandibular Joint Disorders, run by Cairo University at 1 site in Egypt.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 13 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Craniovertebral Angle (CVA) assessment (time frame: 8 weeks). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Apr 2026.