Cervical Joint Position Error and Its Association with Bruxism and Pain Severity in Orthodontic Patients

Zoha Malik; Rabia Majeed; Sana Hafeez; Saba Riaz; Abdullah Khalid Qureshi; Aimen Khurrum; Wahiba Raza

doi:10.61919/4dyrhy69

Authors

Zoha Malik Student, Department of Physical Therapy & rehabilitation, School of health Sciences, UMT, Lahore, Pakistan Author
Rabia Majeed Assistant Professor, Department of Physical Therapy & rehabilitation, School of health Sciences, UMT, Lahore, Pakistan Author
Sana Hafeez Assistant Professor, Department of Physical Therapy & rehabilitation, School of health Sciences, UMT, Lahore, Pakistan Author
Saba Riaz Assistant Professor, Department of Physical Therapy & rehabilitation, School of health Sciences, UMT, Lahore, Pakistan Author
Abdullah Khalid Qureshi Clinical physiotherapist, Ehaan Rehabilitation Centre and Therapy Clinic, Lahore, Pakistan Author
Aimen Khurrum Student, Department of Physical Therapy & rehabilitation, School of health Sciences, UMT, Lahore, Pakistan Author
Wahiba Raza Student, Department of Physical Therapy & rehabilitation, School of health Sciences, UMT, Lahore, Pakistan Author

DOI:

https://doi.org/10.61919/4dyrhy69

Keywords:

Cervical joint position error; cervical proprioception; bruxism; orofacial pain; orthodontic patients; sensorimotor control.

Abstract

Background: Cervical proprioception contributes to coordinated head-neck-jaw motor control, and impairment in cervical joint position sense may influence parafunctional jaw activity and pain. In orthodontic patients, occlusal changes and appliance-related neuromuscular adaptation may increase the relevance of cervical sensorimotor assessment. Objective: To determine the association of cervical joint position error with bruxism risk and pain severity among orthodontic patients. Methods: This cross-sectional observational study included 115 orthodontic patients recruited through convenience sampling from dental hospitals and clinics in Lahore, Pakistan. Cervical joint position error was assessed using a laser-based cervical joint position error test and categorized as positive when angular error exceeded 4.5°. Bruxism risk was measured using the Bruxism Evaluation Questionnaire, with scores >15 classified as high risk. Pain severity was assessed using the Visual Analogue Scale and categorized as mild, moderate, or severe. Data were analyzed using IBM SPSS version 27.0.1. Descriptive statistics and Pearson’s chi-square tests were applied, with statistical significance set at p < 0.05. Results: Of 115 participants, 56 (48.7%) had positive cervical joint position error and 88 (76.5%) were classified as high risk for bruxism. A significant association was found between cervical joint position error and bruxism risk, χ²(1) = 24.076, p < 0.001, Cramer’s V = 0.458. Among CJPE-positive participants, 54/56 (96.4%) were at high risk for bruxism compared with 34/59 (57.6%) of CJPE-negative participants. CJPE was also significantly associated with pain severity, χ²(2) = 17.743, p < 0.001, Cramer’s V = 0.393. Moderate-to-severe pain was reported by 41/56 (73.2%) CJPE-positive participants compared with 21/59 (35.6%) CJPE-negative participants. Conclusion: Cervical joint position error was significantly associated with elevated bruxism risk and greater pain severity among orthodontic patients. These findings support the integration of cervical proprioceptive assessment into orthodontic evaluation and highlight the clinical relevance of the cranio-cervico-mandibular system in orthodontic care.

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