Efficacy Of Different Types Of Physiotherapy Approaches In Temporomandibular Disorders

Bitlis Eren University59 enrolled

Overview

The aim of this study is to investigate the efficacy of different types of physiotherapy approaches in cases with cervical myofascial painful TMD.

59 persons with TMD diagnosed by the dentist and with cervical myofascial pain, aged 18-30 years will be randomly allocated, 3 groups. The participants were randomly allocated only exercise group (EG) (n=20), low-level laser therapy plus exercise group (LLLT) (n=17) and manual pressure release plus exercise group (MPR) (n=22). The cases were evaluated and treated by the same physiotherapist for 4 weeks (12 sessions). Pain, pain pressure threshold, temporomandibular joint (TMJ) mobility and disability, forward head posture, head rotation, neck disability, psychological status and quality of life were evaluated. Evaluations were repeated before and after treatment.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Temporomandibular Disorder

Interventions

ExerciseOTHER

Exercise therapy intended in reducing muscle spasm, improving coordination of the mastication muscles and alter the jaw closure pattern.

Low Level Laser TherapyOTHER

LLLT (max output power: 1200mW, wavelength: 808 nm, dosage: 10j/ cm2 Electronica Pagani Laser Tower Light, Italy) 2.5-4j/TrP dosage was applied to MTrP or sensitive points.

Manuel Pressure ReleaseOTHER

MPR technique is a noninvasive method based on pressure on the trigger point in accordance with the patient's tolerance and technique applies supine position relax as much as possible, manuel pressure applied trigger point in neck and mactication muscles

Eligibility

Sex: ALLMin age: 18 YearsMax age: 30 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Cases who have 3 or more symptoms related to TMJ problems * cases who have trigger points in cervical and masticatory muscles * cases who TMD detected by the dentist, * being between the ages of 18-30, * volunteer to participate in the study Exclusion Criteria: * Patients with a positive history of trauma in the face and neck area and neurological disorders * patients undergoing TMJ or cervical region surgery in the last 3 months, * patients who used dental orthotics within 1 month, * patients who have TMJ instability, * patients who have cervical and upper thoracic region, * patients who have active infection and chronic pain, such as trigeminal neuralgia

Locations (1)

Marmara University

Istanbul, Maltepe, Turkey (Türkiye)

Outcomes

Primary Outcomes

Pressure Pain Threshold Assessment

Pressure Pain Threshold (PPT) of an individual's mastication and cervical muscle was measured with an algometer (JTECH Medical Industries, CommanderTMAlgometer), and the applied pressure was increased to 1 cm2/ kg per second. PPT measurements were repeated three times and the average was used for analysis in every participant.

Time frame: Change from baseline pressure pain threshold score in neck and mastication muscles at week 4.

Pain Severity Assessment

To evaluate the general pain severity of the patients, the Visual Analog Scale (VAS), which is the Visual Pain Scale of Turkish, was used. Patients were asked to mark their general pain separately on a 10 cm scale. According to this, "0" indicates that there is no pain, and "10" indicates the most severe pain. The distance between the marked point and the beginning of the line was recorded in centimeters

Time frame: Change from baseline TMJ pain and intensity of head pain, TMJ noise and jaw locking score at week 4.

Jaw Movements Assessment

Maximum mouth opening (MMO) and lateral deviation were measured with a caliper.

Time frame: Change from baseline MMO and lateral deviation score at week 4.

Neck Movements Assessment

Cervical rotations and the craniovertebral angle between C7 and tragus were measured by a goniometer.

Time frame: Change from baseline cervical rotations and craniovertebral angle score at week 4.

Temporomandibular Disorder Severity

The TMD severity in participation is defined by the Craniomandibular Index (CMI) which was developed to provide a standardized measure to the severity of problems in mandibular movement, muscle, and joint tenderness and TMJ noise for use in epidemiological and clinical outcome studies. The instrument was designed to have clearly defined objective criteria, simple clinical methods, and ease in scoring; it is divided into the Palpation Index (PI) and the Dysfunction Index (DI). The means of the subscales were averaged to produce a CMI score ranging from 0 (best) to 1 (worst)

Data from ClinicalTrials.gov

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