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Association between convergence insufficiency and temporomandibular disorder cross-sectional study

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Evaluate whether there is an association between convergence insufficiency and temporomandibular disorder (TMD) and whether there is an association between pain and range of motion in different degrees of TMD.


We evaluated 138 individuals with TMD and 46 without TMD using the Research Diagnostic Criteria for temporomandibular disorders, the Fonseca Anamnestic Index (FAI), Numeric Pain Rating Scale, and the measurement of mandibular range of motion (ROM). Convergence insufficiency was diagnosed using the convergence test and Convergence Insufficiency Symptom Survey. Analysis of variance was used to compare age and mandibular ROM. The Kruskal–Wallis was used to compare mandibular ROM and pain between groups. The chi-square test was used to evaluate associations between TMD subgroups and the FAI, sex, and ocular convergence.


The majority of individuals without TMD did not exhibit convergence insufficiency. The frequency convergence insufficiency was significantly higher among individuals with severe TMD (p < 0.003). Mean pain severity differed between individuals with and without TMD. Mandibular ROM diminished with the increase in TMD severity.


Convergence insufficiency, age, the increase in pain, and the reduction in mandibular range of motion were associated with the degrees of TMD severity. Despite the significant associations between convergence insufficiency and both pain and TMD severity, these variables cannot be indicated as predictive factors due to the low variability in the linear regression analysis.

Clinical relevance

The present findings can assist in decision making regarding the treatment of severe TMD and the evaluation of ocular convergence.

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The authors are grateful to Nove de Julho University, represented by Dean Prof. Eduardo Esterópoli, Director João Carlos Ferrari of the Rehabilitation Sciences and all study participants.


The work was supported by the Department of Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho—UNINOVE.

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Authors and Affiliations



Douglas Meira dos Santos: data collection and analysis, critical revision, and final approval of the manuscript. Ludmila Menezes Alves de Azevedo: screening of participants. Rita de Cássia das Neves Martins: screening of participants. Felipe Cunha Ricci: screening of participants. Kelly Sayuri Yun Masuda: data collection. Erika Maria Muramoto do Nascimento: data collection. Cid Andre Fidelis de Paula Gomes: conception and design and final approval of the manuscript. Fabiano Politti: data analysis. Itana Lisane Spinato: data analysis. Daniela Aparecida Biasotto-Gonzalez: conception and design, statistical analysis, manuscript writing, and final approval of the manuscript.

Corresponding author

Correspondence to Daniela Aparecida Biasotto-Gonzalez.

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Conflict of interest

Douglas Meira dos Santos declares that he has no conflict of interest. Fabiano Politti declares that he has no conflict of interest. Ludmila Menezes Alves de Azevedo declares that she has no conflict of interest. Rita de Cássia das Neves Martins declares that she has no conflict of interest. Felipe Cunha Ricci declares that he has no conflict of interest. Kelly Sayuri Yun Masuda declares that he has no conflict of interest. Erika Maria Muramoto do Nascimento declares that he has no conflict of interest. Itana Lisane Spinato declares that she has no conflict of interest. Cid Andre Fidelis de Paula Gomes declares that he has no conflict of interest. Daniela Aparecida Biasotto-Gonzalez declares that she has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance Resolution number 466/12 of the Brazilian National Board of Health and received approval from the ethics committee of Nove de Julho University (certificate number 12416319.9.0000.5511).

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Informed consent was obtained from all individual participants included in the study.

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dos Santos, D.M., Politti, F., de Azevedo, L.M.A. et al. Association between convergence insufficiency and temporomandibular disorder cross-sectional study. Clin Oral Invest 25, 851–858 (2021).

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