Efficacy Of Different Types Of Physiotherapy Approaches In Temporomandibular Disorders

Temporomandibular Disorder Clinical Trial

Official title:

Efficacy Of Different Types Of Physiotherapy Approaches In Temporomandibular Disorders

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04294602
• Other study ID #: BitlisErenU1
• Status: Completed
• Phase: N/A
• Start date: May 15, 2017
• Est. completion date: May 10, 2018

Study information

• Verified date: March 2020
• Source: Bitlis Eren University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

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

Description:

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 59
• Est. completion date: May 10, 2018
• Est. primary completion date: March 13, 2018
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 30 Years

Eligibility

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

Related Conditions & MeSH terms

• Disease
• Temporomandibular Disorder
• Temporomandibular Joint Disorders
• Temporomandibular Joint Dysfunction Syndrome

Intervention

Other:
• Exercise
Exercise therapy intended in reducing muscle spasm, improving coordination of the mastication muscles and alter the jaw closure pattern.
• Low Level Laser Therapy
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 Release
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
• Patient Education
Some suggestions were made to TMD people who should pay attention to in daily life. These suggestions were given in writing.

Locations

Country	Name	City	State
Turkey	Marmara University	Istanbul	Maltepe

Sponsors (2)

Lead Sponsor	Collaborator
Bitlis Eren University	Marmara University

Country where clinical trial is conducted

Turkey, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	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.	Change from baseline pressure pain threshold score in neck and mastication muscles at week 4.
Primary	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	Change from baseline TMJ pain and intensity of head pain, TMJ noise and jaw locking score at week 4.
Primary	Jaw Movements Assessment	Maximum mouth opening (MMO) and lateral deviation were measured with a caliper.	Change from baseline MMO and lateral deviation score at week 4.
Primary	Neck Movements Assessment	Cervical rotations and the craniovertebral angle between C7 and tragus were measured by a goniometer.	Change from baseline cervical rotations and craniovertebral angle score at week 4.
Primary	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)	Change from baseline temporomandibular disorder severity score at week 4
Primary	Quality of Life Assesment	Short Form-36 questionnaire contains the physical and mental component, which is evaluated, is close to 100, indicating an increase in health-related quality of life. The means SF-36 score ranging from 0 (worst) to 100 (best).	Change from baseline quality of life score at week 4
Secondary	Neck Disability Assesment	Northwick Park Neck Pain Questionnaire; Neck pain severity, neck pain and sleep, numbness and tingling in the arms at night, duration of symptoms and complaints, weight-bearing, reading and watching television, work and housework, social activities and driving includes 9 items. Each item consists of 5 options, the level of disability increases as you approach 36 points. The means northwick park neck pain questionnaire score ranging from 0 (best) to 36 (worst).	Change from baseline neck disability score at week 4.
Secondary	Psychological Status Assesment	Beck depression index which is a two-factor scale, emotion and somatic, has 21 questions, the lowest score is 0 and the highest score is 3 in each question. The means Beck depression index score ranging from 0 (best) to 63 (worst).	Change from baseline psychological status score at week 4.