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Completed

NCT Number: NCT07456748

Upper Cross Syndrome and Temporomandibular Dysfunction in University Students

This cross-sectional observational study aims to investigate the relationship between Upper Cross Syndrome (UCS), a postural imbalance characterized by forward head posture and rounded shoulders, and Temporomandibular Disorder (TMD) in university students aged 18-35 years. TMD is a musculoskeletal condition affecting the jaw joint and masticatory muscles, commonly associated with pain, limited mandibular movement, and joint sounds. Since cervical posture and jaw function are anatomically and biomechanically interconnected, postural alterations seen in UCS may be associated with temporomandibular dysfunction. In this study, participants will undergo a single-session assessment including postural angle measurements (craniovertebral angle, head-shoulder angle, thoracic kyphosis angle), temporomandibular joint clinical examination, mandibular range of motion measurements, and completion of the OHIP-14 questionnaire. No intervention will be applied.The findings are expected to contribute to understanding the association between upper body posture and jaw dysfunction in young adults and may provide guidance for interdisciplinary assessment and preventive strategies.

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Key information

Conditions

Upper Cross Syndrome Craniomandibular Disorders Jaw Diseases Joint Diseases Mandibular Diseases Muscular Diseases Musculoskeletal Diseases Oculocerebral hypopigmentation syndrome type Preus Stomatognathic Diseases Temporomandibular Disorder (TMD) Temporomandibular Joint Disorders

Age range

18 year–35 year

Sex eligibility

All sexes

Study type

Observational

Primary location

University of Healt Sciences, Gülhane Faculty ofHealth Sciences

Ankara, 06018, Turkey (Türkiye)

About this study

Temporomandibular Disorder is a musculoskeletal condition affecting the temporomandibular joint and masticatory muscles, and it may lead to pain, mandibular movement limitations, joint sounds, and functional impairment. Upper Cross Syndrome is a postural imbalance involving the head, cervical spine, and shoulder girdle, commonly characterized by forward head posture, rounded shoulders, and increased thoracic kyphosis. The cervical spine, shoulder girdle, and temporomandibular region are anatomically and biomechanically interconnected. Alterations in head and shoulder posture may influence mandibular function through changes in muscle activity, joint loading, and cervical alignment. Therefore, postural changes associated with Upper Cross Syndrome may be related to temporomandibular symptoms and functional limitations. This observational cross-sectional study is designed to examine the correlation between Upper Cross Syndrome-related postural parameters and temporomandibular disorder-related clinical findings in university students aged 18-35 years. No intervention will be applied, and all assessments will be completed during a single assessment session. Participants will complete demographic and clinical information forms and the Oral Health Impact Profile-14 questionnaire to assess oral health-related quality of life. Temporomandibular joint assessment will include clinical examination and mandibular range of motion measurements, including maximum mouth opening, lateral deviation, and protrusion. Postural assessment will include craniovertebral angle, head-shoulder angle, and thoracic kyphosis angle measurements. Craniovertebral angle and head-shoulder angle will be assessed using standardized lateral-view photographs through the PhysioMaster® digital photogrammetry application. Thoracic kyphosis angle will be measured using the inclinometer function of the same application.The data obtained from this study will be used to examine the correlation between upper body postural alignment and temporomandibular dysfunction-related findings. The results may contribute to a better understanding of the relationship between posture and jaw function in young adults and may provide guidance for interdisciplinary assessment approaches

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • University students aged between 18 and 35 years
  • Voluntary participation
  • Signed informed consent

Exclusion criteria

  • History of jaw surgery
  • Presence of scoliosis or spinal disorders
  • History of shoulder or spinal surgery
  • Botulinum toxin injection in the facial or jaw region within the past year
  • Diagnosis of rheumatologic disease
  • Neurological, autoimmune, or significant psychological disorders
  • Known cervical pathology within the past year

Treatment and study plan

No Intervention: Observational Cohort

Other

No intervention is administered. Participants undergo clinical TMJ assessment, mandibular range of motion measurements, and postural photography-based angle measurements.

Primary outcomes

  1. Correlation Between Craniovertebral Angle and Mandibular Range of Motion

    Time frame: At single assessment, Day 1

    The correlation between craniovertebral angle and mandibular range of motion will be assessed. Craniovertebral angle will be measured in degrees using standardized lateral-view digital photogrammetry with the PhysioMaster® application. Mandibular range of motion will include maximum mouth opening, right lateral deviation, left lateral deviation, and protrusion. Each mandibular movement will be measured separately in millimeters using a ruler and correlated with the craniovertebral angle measured in degrees using PhysioMaster® digital photogrammetry.

  2. Correlation Between Head-Shoulder Angle and Mandibular Range of Motion

    Time frame: At single assessment, Day 1

    The correlation between head-shoulder angle and mandibular range of motion will be assessed. Head-shoulder angle will be measured in degrees using standardized lateral-view digital photogrammetry with the PhysioMaster® application. Mandibular range of motion will include maximum mouth opening, right lateral deviation, left lateral deviation, and protrusion. Each mandibular movement will be measured separately in millimeters using a ruler and correlated with the head- shoulder angle measured in degrees using PhysioMaster® digital photogrammetry.

  3. Correlation Between Thoracic Kyphosis Angle and Mandibular Range of Motion

    Time frame: At single assessment, Day 1

    The correlation between thoracic kyphosis angle and mandibular range of motion will be assessed. Thoracic kyphosis angle will be measured in degrees using the inclinometer feature of the PhysioMaster® application. Mandibular range of motion will include maximum mouth opening, right lateral deviation, left lateral deviation, and protrusion. Each mandibular movement will be measured separately in millimeters using a ruler and correlated with the kyphosis angle measured in degrees using PhysioMaster® digital photogrammetry..

  4. Correlation Between Postural Angle Measurements and Oral Health Impact Profile-14 Score

    Time frame: At single assessment, Day 1

    The correlation between each postural angle measurement and oral health-related quality of life will be assessed. Postural angle measurements will include thoracic kyphosis angle, head-shoulder angle, and craniovertebral angle, each measured separately using PhysioMaster®. Oral health-related quality of life will be assessed using the Oral Health Impact Profile-14 (OHIP-14) questionnaire. The total OHIP-14 score ranges from 0 to 56, with higher scores indicating a worse outcome.

  5. Correlation Between Mandibular Range of Motion and Oral Health Impact Profile-14 Score

    Time frame: At single assessment, Day 1

    The correlation between each mandibular range of motion measurement and oral health-related quality of life will be assessed. Mandibular range of motion will include maximum mouth opening, right lateral deviation, left lateral deviation, and protrusion, each measured separately in millimeters using a ruler. Oral health-related quality of life will be assessed using the Oral Health Impact Profile-14 questionnaire. The total score ranges from 0 to 56, with higher scores indicating a worse outcome.

Secondary outcomes

  1. Mandibular Range of Motion

    Time frame: At single assessment, Day 1

    Maximum mouth opening, lateral deviation, and protrusion measured in millimeters using a ruler.

  2. Oral Health Impact Profile-14 (OHIP-14) Score

    Time frame: At single assessment, Day 1

    Oral health-related quality of life will be assessed using the Oral Health Impact Profile-14 questionnaire. The questionnaire consists of 14 items grouped under 7 domains. Each item is scored on a 5-point Likert scale from 0 = never to 4 = very often. The total score ranges from 0 to 56. Higher scores indicate a worse outcome, reflecting a greater negative impact of oral health-related problems on quality of life.

  3. Craniovertebral Angle

    Time frame: At single assessment, Day 1

    Craniovertebral angle will be measured in degrees using standardized lateral-view digital photogrammetry with the PhysioMaster® application. This measurement will be used to assess forward head posture.

  4. Head-Shoulder Angle

    Time frame: At single assesment, Day 1

    Head-shoulder angle will be measured in degrees using standardized lateral-view digital photogrammetry with the PhysioMaster® application. This measurement will be used to assess rounded shoulder posture.

  5. Thoracic Kyphosis Angle

    Time frame: At single assessment, Day 1

    Thoracic kyphosis angle will be measured in degrees using the inclinometer feature of the PhysioMaster® application. This measurement will be used to assess thoracic kyphosis.

Sponsors and collaborators

Lead sponsor

Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey

Other

Registry information

Official study title

Investigation of the Association Between Upper Crossed Syndrome and Temporomandibular Joint Dysfunction in University Students: An Observational Cross-Sectional Study

Acronym: UCS-TMD

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Mar 6, 2026
Registry last updated
May 7, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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