Effects of oral motor exercises and laser therapy on chronic temporomandibular disorders: a randomized study with follow-up (original) (raw)
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International Journal of Physiotherapy and Research, 2018
Background: Temporomandibular joint dysfunctions (TMJDs) are considered the most common chronic orofacial pain condition characterized by pain in the temporomandibular joint (TMJ) area, masticatory muscles and associated musculoskeletal structures with the affection of mouth opening. Conventional therapy and low-level laser therapy (LLLT) are safe and noninvasive modalities that each therapist focuses on to relieve pain and increase function. Objective: The purpose of this study was to investigate the effect of conventional therapy and low-level laser therapy on pain and limitations of daily functions in patients with temporomandibular joint dysfunction (TMJD). Methods: Sixty patients (45 females and 15 males) with myofascial pain syndrome of TMJ were divided randomly into study and control groups. The study group received conventional therapy consisting of active and stretching exercises for mandibular muscles with ultrasound and LLLT application on TMJ area. Control group received conventional therapy only. Pressure pain threshold was evaluated using hand-held pressure algometer and pain-related limitations in daily functions were evaluated by the limitations in daily functions-temporomandibular disorders questionnaire (LDF-TMDQ) at baseline and 4 weeks after the treatment. Results: There was a significant decrease (p < 0.05) in limitations in daily functions, with a significant increase (p < 0.05) in pressure pain threshold for TMJ, masseter and anterior temporalis muscles at both sides in the study group compared with control group. Conclusion: The combination of conventional therapy with LLLT was more effective in pain relief and improvement of limitations in daily functions than does conventional therapy alone for patients with temporomandibular joint dysfunctions.
A pilot study on the use of low level laser therapy in treatment of temporomandibular disorder
2018
Temporomandibular disorders (TMDs) is a collective term that embracing a number of clinical problems that involve the masticatory muscles, Temporomandibular Joint (TMJs), and the associated structures. It characterized by facial pain in the area of TMJ and muscle of mastication, restriction and sound during mandibular movement. Recently physical therapy such as Low Level Laser Therapy (LLLT) is used as one of the treatment modalities and it is believed to promote wound healing, tissue repair and induce analgesia. Convenience sampling was used which consist of 22 volunteered patients, 14 were treated with conventional treatment and 8 were treated with combination of LLLT and conventional therapy. Laser machine used was Waterlase/Biolase © 2007 with irradiation 0.5 W-30 Hz daily for three consecutive days, then once a week review treatment for two weeks. The space between laser beam and skin is 3 cm, applied as small circles for 2-3 minutes. Pain intensity before and after the treatment was recorded by using numerical rating scale (NRS). Statistical data analysis was conducted using SPSS software. Wilcoxon-sign ranked-test and Mann-Whitney U test were used. Pain intensity was reduced significantly in patients whom treated by combination of LLLT and conventional therapy. (p<0.05). Pain intensity after treatment for female were higher (M=1.20, SD=1.10) than for male (M=0.00, SD=0.00). Younger patients have higher pain intensity than older patients. LLLT is effective to be used as adjunct to the current conventional treatment in relieving pain in TMDs. Clinical article (J Int Dent Med Res 2018; 11(2): pp. 669-675
Impaired orofacial motor functions on chronic temporomandibular disorders
Journal of Electromyography and Kinesiology, 2014
Because temporomandibular disorders (TMDs) rehabilitation continues to be a challenge, a more comprehensive picture of the orofacial functions in patients with chronic pain is required. This study assessed the orofacial functions, including surface electromyography (EMG) of dynamic rhythmic activities, in patients with moderate-severe signs and symptoms of chronic TMD. It was hypothesized that orofacial motor control differs between patients with moderate-severe chronic TMD and healthy subjects. Seventy-six subjects (46 with TMD and 30 control) answered questionnaires of severity of TMD and chewing difficulties. Orofacial functions and EMG during chewing were assessed.
Research, Society and Development, 2021
Introduction: Temporomandibular disorders (TMD) - recognized as the most common chronic orofacial pain condition - significantly impacts individuals’ quality of life and social coexistence. Therefore, this study aimed to analyze the effects of low-level laser therapy (LLLT) on functional improvements in the temporomandibular joints (TMJ). Method: The research was carried out at the Universidade Federal do Piaui on 32 young adults with signs and symptoms of TMD, who were divided into the intervention group (IG) and the control group (CG). The IG was administered the LLLT application directly on the TMJ. While both groups were subjected to the same procedures, for the CG, the laser device was turned off. Results: The mean age of the participants was 21.87 ± 2.4 years, with a predominance of females (87.5%) over males (12.5%). Homogeneity was observed between the CG and IG concerning the presence of pain from palpation. The decrease in the pain of the musculature was relevant, with emp...
Efficiency and Jaw Movement Before and After Temporomandibular Disorder Treatment.
In this clinical study, pre-and post-rehabilitation changes in intraborder mandible movements, chewing cycles, masticatory efficiencies, and borders of the chewing area of patients with unilateral muscular disorders (MD) (n=20) or unilateral disc derangement disorders (DDD) (n=20) of temporomandibular disorder (TMD) were observed and compared with healthy individuals with full dentition (n=20) (48 female, 12 male; mean age: 28). The MD patients received stabilization splints and the DDD patients, anterior positioning splints for six weeks. Symptoms, such as muscle pain, TMJ pain, headache, chewing difficulty, and maximum mouth opening, showed significant improvements after splint therapy for both MD (p=0.000) and DDD (p=0.000) patients, but lateral excursion and protrusion were not significantly changed (p>0.05). Chewing efficacy and chewing cycles improved significantly (p<0.05) in both the MD (p<0.05) and DDD (p<0.05) groups, but only the MD group was comparable to the control group after treatment. Pre-and post-rehabilitation chewing cycles along the frontal plane on both sides in the MD group were similar to the control group. Considering the majority of the improvements in the diagnostic measures, patients with MD and DDD may benefit from occlusal splint therapy.
Lasers in Medical Science, 2013
Low-level laser therapy (LLLT) has been commonly used for the treatment of painful musculoskeletal conditions, but the results of previous studies on this subject are controversial. The aim of this study was to evaluate the efficacy of LLLT in the management of patients with myogenic temporomandibular joint disorders (TMDs). In this randomized, double-blind clinical trial, 20 patients with myogenic TMD were randomly divided into laser and placebo groups. In the laser group, a pulsed 810-nm low-level laser (average power 50 mW, peak power 80 W, 1,500 Hz, 120 s, 6 J, and 3.4 J/cm 2 per point) was used on painful muscles three times a week for 4 weeks. In the placebo group, the treatment was the same as that in the laser group, but without energy output. The patients were evaluated before laser therapy (T1), after six sessions of laser application (T2), at the end of treatment (T3), and 1 month after the last application (T4), and the level of pain and the amount of mouth opening were measured. There was a significant increase in mouth opening and a significant reduction of pain symptoms in the laser group (p<0.05). A similar improvement was not observed in the placebo group (p>0.05). Between-group comparisons revealed no significant difference in pain intensity and mouth opening measurement at any of the evaluation time points (p > 0.05). LLLT can produce a significant improvement in pain level and mouth opening in patients affected with myogenic TMD.
BMC musculoskeletal disorders, 2017
Temporomandibular Disorders (TMD) may be characterized by pain and restricted jaw movements. In the absence of somatic factors in the temporomandibular joint, mainly myogenous, psychobiological, and psychosocial factors may be involved in the aetiology of myogenous TMD. An occlusal appliance (splint) is commonly used as a basic therapy of the dental practice. Alternatively, a type of physiotherapy which includes, apart from massage of sore muscles, aspects of cognitive-behavioural therapy might be a basic therapy for myogenous TMD. Treatment outcome of physiotherapy (Ph-Tx) was evaluated in comparison to that of splint therapy (Sp-Tx), using the index Treatment Duration Control (TDC) that enabled a randomized controlled trial with, comparable to clinical care, therapy-and-patient-specific treatment durations. Seventy-two patients were randomly assigned to either Ph-Tx or Sp-Tx, with an intended treatment duration between 10 and 21 or 12 and 30 weeks respectively. Using TDC, the clin...
Cranio : the journal of craniomandibular practice, 2005
The literature is replete with theories regarding temporomandibular disorders (TMD). However, there is a paucity of information concerning perceived malocclusion and other teeth-related signs and symptoms after full-mouth rehabilitation. This clinical study was designed to evaluate the perception of TMD patients concerning perceived malocclusion and other teeth-related signs and symptoms after full-mouth rehabilitation guided by the Mental Analog Scale (MAS). Among 38 patients referred for full-mouth rehabilitation, 20 were diagnosed as having TMD after reviewing a questionnaire, recording the major complaints and symptoms, in addition to performing comprehensive clinical examination. Nonsurgical therapy was performed, including fabricating an anterior programming device, a centric relation occlusal device and finally full-mouth rehabilitation by means of placing crowns on all upper and/or lower teeth. All full-mouth rehabilitation procedures were performed using a fully adjustable ...
Journal of Applied Oral Science
Are exercises with or without occlusal splints more effective in the reduction of pain in patients with temporomandibular disorders of myogenic origin? A systematic review Temporomandibular disorders (TMD) is a term used to describe a set of clinical conditions that may compromise the temporomandibular joint (TMJ) and masticatory muscles and/or associated structures, considered the most frequent cause of orofacial pain of non-dental origin. In recent years, many forms of physical therapy have been used in the treatment of TMD to reduce pain and improve the range of mandibular movement present in this impairment. Among these resources are kinesiotherapy (exercise), electrothermal and manual therapy, acupuncture, training posture, mobilizations, and biofeedback. Objectives: To determine if exercises with or without occlusal splints are effective in reducing pain in patients with temporomandibular disorders (TMD) of myogenic origin. Methodology: This systematic review was registered in the International Prospective Register of Systematic Reviews (CRD 42019134244). Controlled trials published in PubMed, Scopus, and Cochrane Library following PRISMA guidelines up to April 2022 were randomized and included. The population above 18 years, which evaluated the effectiveness of exercise with or without occlusal splints in reducing pain in patients with TMD of myogenic origin, diagnosed through the Research Diagnostic Criteria for Temporomandibular Disorders, was also included. There was no restriction on the period of publication. Cochrane risk of bias analysis was performed. Results: Of the five included articles, all showed a reduction of pain, but without significant differences between the interventions performed. Additionally, studies that evaluated the quality of life and mandibular movements showed a reduction in pain, but no significant differences between therapies. Conclusion: The analyzed studies showed no difference in the improvement of pain, quality of life, and mandibular movements between the groups that performed only exercises or the associated treatments.