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Journals / Batı Karadeniz Tıp Dergisi / 2026 / Cilt: 10 Sayı: 1

Investigation of factors associated with the level of temporomandibular dysfunction in university students

Üniversite öğrencilerinde temporomandibular disfonksiyon düzeyi ile ilişkili faktörlerin incelenmesi

Merve Bulguroğlu(Department of Physiotherapy and Rehabilitation, Ankara Medipol University, Faculty of Health Sciences, Ankara, Türkiye)0000-0002-5923-4720
Halil İbrahim Bulguroğlu(Department of Physiotherapy and Rehabilitation, Ankara Medipol University, Faculty of Health Sciences, Ankara, Türkiye)0000-0002-6767-7062
Gökçe Kılıç(Dr. Dt. Gökçe Kılıç Private Dental Clinic, Ankara, Türkiye)0009-0009-3925-8395
Selcan Suiçmez(Department of Physiotherapy and Rehabilitation, Ankara Medipol University, Faculty of Health Sciences, Ankara, Türkiye)0009-0009-0354-8630
Serenay Zorlu(Department of Physiotherapy and Rehabilitation, Ankara Medipol University, Faculty of Health Sciences, Ankara, Türkiye)0000-0002-3079-8688
Cansu Gevrek Aslan(Department of Physiotherapy and Rehabilitation, Ankara Medipol University, Faculty of Health Sciences, Ankara, Türkiye)0000-0003-0750-3033
Pages
1–8
Publication Date
2026-03-12
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

This study highlights the importance of evaluating TMD and related symptoms in university students.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aim: Temporomandibular disorders (TMD) and factors associated with them are frequently observed in university students.
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Key Findings & Data:Material and Methods: Our cross-sectional study included 228 students from the Department of Physiotherapy and Rehabilitation at Ankara Medipol University.
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Conclusion & Impact:This study highlights the importance of evaluating TMD and related symptoms in university students.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:Öğrenciler · postür · stres

Abstract

Aim: Temporomandibular disorders (TMD) and factors associated with them are frequently observed in university students. The aim of this study was to investigate the relationship between different severities of TMD and deep neck flexor muscle endurance, craniovertebral angle, upper neck mobility, and stress levels in university students. Material and Methods: Our cross-sectional study included 228 students from the Department of Physiotherapy and Rehabilitation at Ankara Medipol University. TMD severity was assessed using the Fonseca Anamnestic Index (FAI), deep neck flexor muscle endurance using the Craniocervical flexion test (CCFT), head-forward posture using the craniovertebral angle (CVA), upper neck mobility using the cervical flexion- rotation test (CFRT), and stress levels using the Perceived Stress Scale (PSS). Results: Moderate negative correlations were found between FAI and CVA (r=-0.495, p<0.001), CFRT-right (r=-0.486, p<0.001), and CFRTleft (r=-0.443, p<0.001). Weak negative correlations were observed between FAI and both the deep neck flexor activation score (r=-0.352, p<0.001) and performance index score (r=-0.323, p<0.001). In addition, a weak positive correlation was found between FAI and PSS (r=0.327, p<0.001). Significant differences were observed in all measurements across the four TMD severity groups (p<0.05). Conclusion: TMD in university students is associated with craniovertebral angle, deep neck flexor muscle endurance, upper neck mobility, and stress levels. As TMD severity increases, all these parameters are negatively affected. This study highlights the importance of evaluating TMD and related symptoms in university students.

Özet

Amaç: Üniversite öğrencilerinde temporomandibular bozukluklar (TMB) ve bu bozukluklarla ilişkili faktörler sıklıkla gözlemlenmektedir. Bu çalışmanın amacı, üniversite öğrencilerinde farklı temporomandibular bozukluk şiddetleri ile derin boyun fleksör kas dayanıklılığı, kraniovertebral açı, üst boyun mobilitesi ve stres düzeyleri arasındaki ilişkiyi incelemektir. Gereç ve Yöntemler: Kesitsel bir çalışma olarak planlanan araştırmamıza, Ankara Medipol Üniversitesi Fizyoterapi ve Rehabilitasyon bölümünden çalışmaya 228 öğrenci dahil edildi. Bireylerin TMB şiddeti Fonseca Anamnestik İndeksi (FAİ) ile, derin boyun fleksör kas enduransı Kranioservikal fleksiyon testi (KSFT) ile, baş önde postür kraniovertebral açı (KVA) ile, üst boyun mobilitesi servikal fleksiyon-rotasyon testi (SFRT) ile, stres düzeyleri ise Algılanan Stres Ölçeği (ASÖ) kullanılarak değerlendirildi. Bulgular: FAİ ile KVA (r=-0.495, p<0.001), SFRT-sağ (r=-0.486, p<0.001) ve SFRT-sol (r=-0.443, p<0.001) arasında orta düzeyde negatif anlamlı bir korelasyon bulundu. Derin boyun fleksörleri-aktivasyon skoru (r=-0.352, p<0.001) ve derin boyun fleksörleri-performans indeks skoru (r=-0.323, p<0.001) ile FAİ arasında zayıf düzeyde negatif anlamlı bir korelasyon belirlendi. Ayrıca, FAİ ile ASÖ arasında zayıf düzeyde pozitif anlamlı bir korelasyon saptandı (r=0.327, p<0.001). TMB şiddeti farklı olan dört grup arasında tüm ölçüm sonuçlarında anlamlı fark bulundu (p<0.05). Sonuç: Üniversite öğrencilerinde temporomandibular bozukluklar, kraniovertebral açı, derin boyun fleksör kas dayanıklılığı, üst servikal mobilite ve stres düzeyleri ile ilişkilidir. Bozukluk şiddeti arttıkça tüm bu parametreler olumsuz yönde etkilenmektedir. Bu çalışma, üniversite öğrencilerinde TMB ve ilişkili semptomların değerlendirilmesinin önemini vurgulamaktadır.

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Cite This Article

Bulguroğlu, M., Bulguroğlu, H. İ., Kılıç, G., Suiçmez, S., Zorlu, S., Aslan, C. G. (2026). Investigation of factors associated with the level of temporomandibular dysfunction in university students. Batı Karadeniz Tıp Dergisi, Cilt: 10 Sayı: 1, 1–8. https://doi.org/10.29058/mjwbs.1698765

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References (34)

  1. Kapos FP, Exposto FG, Oyarzo JF, Durham J. Temporomandibular disorders: a review of current concepts in aetiology, diagnosis and management. Oral Surg. 2020;13(4):321-334. https://doi.org/10.1111/ors.12473
  2. Akarca EM, Karabulut Açıkgöz T, Senyilmaz D, Canay S. Prevalence and Severity of Temporomandibular Disorders among the Turkish Dental Students Using Fonseca's Anamnestic Index. Clin Dent Res. 2025;49(2):110-8.
  3. Altın FN, Aslan Telci E, Özden F. Evaluation of factors associated with the temporomandibular joint dysfunction in university students. Bull Fac Phys Ther. 2024;29:83. https://doi.org/10.1186/s43161-024-00249-9
  4. Yüzbaşıoğlu Ü, Kaynak BA, and Taş S. Assessment of Cervical Joint Position Sense and Head Posture in Individuals with Myogenic Temporomandibular Dysfunctions and Identifying Related Factors: A Case-Control Study. J Oral Rehabil. 2025;52:160-8. https://doi.org/10.1111/joor.13885
  5. Lam AC, Liddle LJ, and MacLellan CL. The Effect of Upper Cervical Mobilization/Manipulation on Temporomandibular Joint Pain, Maximal Mouth Opening, and Pressure Pain Thresholds: A Systematic Review and Meta-Analysis. Arch Rehab Res Clin. 2022;5:100242. https://doi.org/10.1016/j.arrct.2022.100242
  6. Grondin F, Hall T, Laurentjoye M, Ella B. Upper cervical range of motion is impaired in patients with temporomandibular disorders. Cranio. 2015;33(2):91-99. https://doi.org/10.1179/0886963414Z.00000000053
  7. Ferreira MP, Waisberg CB, Conti PCR, Bevilaqua-Grossi D. Mobility of the upper cervical spine and muscle performance of the deep flexors in women with temporomandibular disorders. J Oral Rehabil. 2019;46(12):1177-1184. https://doi.org/10.1111/joor.12858
  8. Miçooğulları M, Yüksel İ, and Angın S. Effect of pain on cranio-cervico-mandibular function and postural stability in people with temporomandibular joint disorders. Korean J Pain. 2024;37:164-77. https://doi.org/10.3344/kjp.23301
  9. Yao Y, Cai B, Fan S, Yang HX, Zhang YX, Xu LL. The association between forward head posture and masticatory muscle pressure pain thresholds in patients with temporomandibular joint dissorders: a cross-sectional observational study. Clin Oral Investig. 2023;27(1):353-360. https://doi.org/10.1007/s00784-022-04739-9
  10. Dos Santos EA, Peinado BRR, Frazão DR, Né YGS, Fagundes NCF, Magno MB, Maia LC, Lima RR, de Souza-Rodrigues RD. Association between temporomandibular disorders and anxiety: A systematic review. Front Psychiatry.2022;13:990430. https://doi.org/10.3389/fpsyt.2022.990430
  11. Augusto VG, Perina KCB, Penha DSG, Dos Santos DCA, Oliveira VAS. Temporomandibular Dysfunction, Stress and Common Mental Disorder in University Students. Acta Ortop Bras. 2016;24:330-3. https://doi.org/10.1590/1413-785220162406162873
  12. Eitivipart AC, Viriyarojanakul S, and Redhead L. Musculoskeletal disorder and pain associated with smartphone use: A systematic review of biomechanical evidence. Hong Kong Physiother J. 2018;38:77-90. https://doi.org/10.1142/S1013702518300010
  13. Fonseca DMD, Bonfante G, Valle ALD, Freitas SFTD. Diagnóstico pela anamnese da disfunção craniomandibular. RGO. 1994; 42:23-28.
  14. Kaynak BA, Taş S, and Salkın Y. The accuracy and reliability of the Turkish version of the Fonseca anamnestic index in temporomandibular disorders. Cranio. 2023;41:78-83. https://doi.org/10.1080/08869634.2020.1812808
  15. Jull GA, O'Leary SP, and Falla DL. Clinical assessment of the deep cervical flexor muscles: the craniocervical flexion test. J Manipulative Physiol Ther. 2008;3:525-33. https://doi.org/10.1016/j.jmpt.2008.08.003
  16. Kelly M, Cardy N, Melvin E, Reddin C, Ward C, Wilson F. The craniocervical flexion test: an investigation of performance in young asymptomatic subjects. Man Ther. 2013;18(1):83-86. https://doi.org/10.1016/j.math.2012.04.008
  17. Salahzadeh Z, Maroufi N, Ahmadi A, et al. Assessment of forward head posture in females: observational and photogrammetry methods. J Back Musculoskelet Rehabil. 2014;27(2):131-139. https://doi.org/10.3233/BMR-130426
  18. Jabbar KM and Gandomi F. The comparison of two corrective exercise approaches for hyperkyphosis and forward head posture: A quasi-experimental study. J Back Musculoskelet Rehabil. 2021;34:677-87. https://doi.org/10.3233/BMR-200160
  19. Takasaki H, Hall T, Oshiro S, Kaneko S, Ikemoto Y, Jull G. Normal kinematics of the upper cervical spine during the Flexion-Rotation Test - In vivo measurements using magnetic resonance imaging. Man Ther. 2011;16(2):167-171. https://doi.org/10.1016/j.math.2010.10.002
  20. Cohen S, Kamarck T, and Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24:385-96. https://doi.org/10.2307/2136404
  21. Eskin M. The adaptation of the perceived stress scale into Turkish: a reliability and validity analysis. Journal of New Symposium. 2013;51:132-40.
  22. Karthik R, Hafila MIF, Saravanan C, Vivek N, Priyadarsini P, Ashwath B. Assessing Prevalence of Temporomandibular Disorders among University Students: A Questionnaire Study. J Int Soc Prev Community Dent. 2017;7(Suppl 1):S24-S29. https://doi.org/10.4103/jispcd.JISPCD_146_17
  23. Özdinç S, Ata H, Selçuk H, Can HB, Sermenli N, Turan FN. Temporomandibular joint disorder determined by Fonseca anamnestic index and associated factors in 18- to 27-year-old university students. Cranio. 2020;38:327-32. https://doi.org/10.1080/08869634.2018.1513442
  24. Farias SJS, Ramos AG, Kogawa EM, Lia EN, de Medeiros RA. Prevalence of self-medication among university students diagnosed with temporomandibular disorders. J Oral Facial Pain Headache. 2024;38:58-63.
  25. Kawasaki T, Ohji S, Aizawa J, Sakai T, Hirohata K, Koseki T, Kuruma H, Okawa A, Jinno T. Characteristics of head and neck alignment and function of deep cervical flexor muscles in patients with nonspecific neck pain. J Bodyw Mov Ther. 2024;39:565-71. https://doi.org/10.1016/j.jbmt.2024.03.063
  26. Çobanoğlu G, Demirkan MY, Ecemiş ZB, Atalay Güzel N. Forward Head Posture and Its Effect on Muscle Activation. Gazi Sağlık Bil. 2024;9:85-93. https://doi.org/10.52881/gsbdergi.1376080
  27. Ikenna UC, Nwobodo LN, Ezeukwu AO, Ilo IJ, Ede SS, Okemuo AJ, Okoh CF. Relationship between the development of musculoskeletal disorders, physical activity level, and academic stress among undergraduates students of University of Nigeria. J Educ Health Promot. 2022;11:399. https://doi.org/10.4103/jehp.jehp_416_22
  28. Kennedy E, Albert M, and Nicholson H. Do longus capitis and colli really stabilise the cervical spine? A study of their fascicular anatomy and peak force capabilities. Musculoskelet Sci Pract. 2017;32:104-13. https://doi.org/10.1016/j.msksp.2017.10.005
  29. Sherwin R, Henricksen J, Kapila J, Adams L, Likness A, Hooper TL, Sizer P. The effect of tongue-to-palate on deep neck flexor activity. J Electromyogr Kinesiol. 2024;79:102938. https://doi.org/10.1016/j.jelekin.2024.102938
  30. Saczuk K, Lapinska B, Wawrzynkiewicz A, Witkowska A, Arbildo-Vega HI, Domarecka M, Lukomska-Szymanska M. Temporomandibular Disorders, Bruxism, Perceived Stress, and Coping Strategies among Medical University Students in Times of Social Isolation during Outbreak of COVID-19 Pandemic. Healthcare (Basel). 2022;10:740. https://doi.org/10.3390/healthcare10040740
  31. Paz-Cortés MM, Martín-Vacas A, Mendoza PA, Rozalén M, Alvaredo MÁ. Analysis of the Effect of Exams on Perceived Stress and Temporomandibular Joint Status in Physiotherapy Students: A Pilot Study. Medicina (Kaunas). 2024;60:952. https://doi.org/10.3390/medicina60060952
  32. Minervini G, Franco R, Marrapodi MM, et al. The Association between COVID-19 Related Anxiety, Stress, Depression, Temporomandibular Disorders, and Headaches from Childhood to Adulthood: A Systematic Review. Brain Sci. 2023;13(3):481. https://doi.org/10.3390/brainsci13030481
  33. Uehara LM, Tardelli JDC, Botelho AL, Valente MLDC, Dos Reis AC. Association between depression and temporomandibular dysfunction in adults - a systematic review. Cranio. 2025;43(3):461-467. https://doi.org/10.1080/08869634.2022.2161985
  34. Ozmen EE, Unuvar BS. The effects of dry needling and face yoga on pain, depression, function, and sleep quality in patients with temporomandibular dysfunction. Explore (NY). 2024;20(5):102980. https://doi.org/10.1016/j.explore.2024.01.006