Abstract
Background: Isolated manual therapy techniques (MT) have shown beneficial effects in patients with temporomandibular disorders (TMD) but the effect of the combination of such techniques, together with the well-stablished splint therapy (ST) remains to be elucidated. Objective: This study was conducted to ascertain whether a combined program of MT techniques, including intraoral treatment, plus traditional ST improves pain and clinical dysfunction in subjects with TMD. Methods: A preliminary trial was conducted. 16 participants were assigned to either the MT plus ST-Experimental Group (EG, n = 8) or the ST alone—Control Group (CG, n = 8). Forty-five minute sessions of combined MT techniques were performed, once a week for four weeks. Three evaluations were conducted: baseline, post-treatment, and one-month follow-up. Outcome measures were pain perception, pain pressure threshold (PPT), TMD dysfunction, and perception of change after treatment. Results: EG showed significant reduction on pain, higher PPT, significant improvement of dysfunction and significantly positive perception of change after treatment (p < 0.05 all). Additionally, such positive effects were maintained at follow-up with a high treatment effect (R2 explaining 26.6–33.2% of all variables). Conclusion: MT plus ST showed reduction on perceived pain (3 points decrease), higher PPT (of at least 1.0 kg/cm2), improvement of disability caused by pain (4.4 points decrease), and positive perception of change (EG: 50% felt “much improvement”), compared to ST alone.
Highlights
Temporomandibular disorders (TMD) are defined by a set of clinical signs that affect the temporomandibular joint (TMJ), the masticatory muscles, and related structures involved in the movements of the TMJ [1].It has a prevalence of over 5% [2], and is characterized by different symptoms and signs which include, TMJ or surrounding tissues pain, generalized myofascial pain, joint noise in the form of clicking and associated with movement, decrease joint movement amplitude, functional limitations, and deviation from jaw opening [1,3]
The positive effects of manual therapy techniques (MT) are maintained over time, since we observed improTvheemceunrtrseenvt epnrealtimfoilnloawryusptu. dy shows that a MT-based protocol combined with splint therapy (ST) tends to imprToovtehsehboerts-taonfdoumridktneormwlceldingiec,atlhpiasriasmtheetefirsrsotfsptuaidny(VtoAeSvaanludaatelgtohme eptoryte)n, steiavleerffiteyc, tdsyosffuandcdtiionng,a parnodtopceorlcienpctliuodnionfgcsheavnegrealinMinTdtievcihdnuiaqlus ewsittoh TthMe DtrawdhiteinoncaolmSpTafroerdTtoMtDhe. tTrhadisitpiorontaolctorelaintmcleundtebdasbeodth aocnceSsTsoarlyonmeo
Our study provides preliminary evidence that MT applied both at the cervical spine and the masticatory area may be beneficial in decreasing pain in patients suffering from temporomandibular disorders (TMD)
Summary
Temporomandibular disorders (TMD) are defined by a set of clinical signs that affect the temporomandibular joint (TMJ), the masticatory muscles, and related structures involved in the movements of the TMJ [1].It has a prevalence of over 5% [2], and is characterized by different symptoms and signs which include, TMJ or surrounding tissues pain, generalized myofascial pain, joint noise in the form of clicking and associated with movement, decrease joint movement amplitude, functional limitations, and deviation from jaw opening [1,3]. Objective: This study was conducted to ascertain whether a combined program of MT techniques, including intraoral treatment, plus traditional ST improves pain and clinical dysfunction in subjects with TMD. Results: EG showed significant reduction on pain, higher PPT, significant improvement of dysfunction and significantly positive perception of change after treatment (p < 0.05 all). Such positive effects were maintained at follow-up with a high treatment effect (R2 explaining 26.6–33.2% of all variables). Conclusion: MT plus ST showed reduction on perceived pain (3 points decrease), higher PPT (of at least 1.0 kg/cm2), improvement of disability caused by pain (4.4 points decrease), and positive perception of change (EG: 50% felt “much improvement”), compared to ST alone
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