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17 December 2025

Effects on Condylar Position of Head Flexion Typically Induced by the Use of Portable Electronic Devices: An Observational Study

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1
Department of Dentistry, Dental School, Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital, 20132 Milan, Italy
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Doctoral School of Dental Medicine, Titu Maiorescu University, 040051 Bucharest, Romania
3
Department of Clinical Medicine, Public Health, Life and Environmental Sciences (MeSVA), University of L’Aquila, 24100 L’Aquila, Italy
*
Author to whom correspondence should be addressed.
Appl. Sci.2025, 15(24), 13245;https://doi.org/10.3390/app152413245 
(registering DOI)
This article belongs to the Special Issue Innovative Materials and Technologies in Orthodontics

Abstract

The widespread use of portable electronic devices has increasingly promoted the prolonged maintenance of non-physiological postures, particularly anterior and downward head flexion. Therefore, this study aimed to analyze the condylar and incisor relationship displacement induced by this improper posture. A total of 20 adult subjects (9 F, 11 M; mean age 27 ± 5) were recruited at the Department of Dentistry, Vita-Salute San Raffaele University, Milan, Italy. Mandibular kinematics was recorded using JMA-Optic AG (Zebris Medical GmbH, Isny, Germany). The protocol adopted consisted of three phases: (1) Habitual occlusion with light clenching, (2) Neuromuscular rest position (RP) verified by surface electromyography (sEMG), (3) Anterior head flexion (40–60°) (HF), simulating the posture typically observed during portable digital device use. Millimetric measurements of condylar displacement from RP to HF and incisal plane changes were collected. Data were analyzed descriptively with Microsoft Excel, and inferentially with StatPlus Pro (AnalystSoft, StatPlus: mac Pro, version 8). The right condyle exhibited a mean displacement of 1.9 mm in the downward direction (p < 0.001), while the left condyle showed a downward displacement of 1.5 mm (p < 0.001). No significant difference was observed between the two sides. At the dental level, the lower incisor revealed a mean shift of 1.0 mm superiorly (p < 0.001) and 0.7 mm anteriorly (p < 0.001). The HF determines a significant condylar and incisal plane displacement, and may predispose individuals to TMJ disorders, supporting the hypothesis of an emerging cranio-cervico-mandibular condition linked to prolonged use of high-tech display terminals, here proposed as ED-TMD (Electronic Device-Induced Temporomandibular Disorder).

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