The aim of this study is to compare the effects of two therapeutic approaches commonly used in the management of muscular temporomandibular disorders (TMD): a multimodal physiotherapy program combining manual therapy and therapeutic exercises, and the use of an occlusal splint during sleep. This study seeks to determine whether these interventions help reduce pain, improve mouth opening, and enhance oral health-related quality of life in adults with muscular TMD. Participants will be assigned to one of two groups: one group will receive a six-week multimodal physiotherapy program, while the other will use an occlusal splint nightly for the same period. Assessments will be conducted at baseline and 48 hours after completion of the intervention. The findings of this study may contribute to improving clinical management and treatment strategies for individuals with TMD.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
24
Participants received multimodal physiotherapy consisting of one 30-minute session per week for six weeks, delivered by a trained physiotherapist. The intervention included manual therapy techniques (compression and transverse and longitudinal massage of the masseter, compression of the medial pterygoid, longitudinal massage of the temporalis, and bilateral stretching of the masseter and medial pterygoid muscles) combined with therapeutic exercises focused on strengthening (resisted mouth opening, closing, and lateral movements) and motor coordination.
Participants received thermoplastic occlusal splint therapy (3 mm thickness) and were instructed to wear the device nightly during sleep for six consecutive weeks. Splint fitting and occlusal adjustments were performed by a qualified dentist to ensure proper adaptation and comfort.
Clínica de Fisioterapia Egas Moniz
Almada, Portugal, Portugal
Unique Smile - Clinica Médica e Dentária
Lisbon, Portugal, Portugal
MedCenter Cascais | Clínica Dentária
Lisbon, Portugal, Portugal
Pain Intensity (Numeric Pain Rating Scale - NPRS)
Pain intensity will be assessed using the Numerical Pain Rating Scale (NPRS), an 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain). Participants will rate their worst pain during daily activities in the previous 24 hours.
Time frame: Baseline and 6 weeks (48 hours after completion of the intervention).
Pressure Pain Threshold - PPT (Algometry)
Pressure pain threshold will be assessed using an analogue algometer applied perpendicularly to the masseter and temporalis muscles bilaterally. Three measurements will be taken at each site and the mean value will be used for analysis.
Time frame: Baseline and 6 weeks (48 hours after completion of the intervention).
Mouth Opening Amplitude (Digital Caliper)
Interincisal distance will be measured in millimetres using a digital caliper during comfortable mouth opening and maximum forced mouth opening. Three trials will be recorded and the mean value will be used for analysis.
Time frame: Baseline and 6 weeks (48 hours after completion of the intervention).
Oral Health-Related Quality of Life (OHIP-14)
Oral health-related quality of life will be assessed using the OHIP-14 questionnaire. Total score is obtained by summing item scores, with higher scores indicating worse oral health-related quality of life.
Time frame: Baseline and 6 weeks (48 hours after completion of the intervention).
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