Effects of Ultrasound, Laser and Exercises on Temporomandibular Joint Pain and Trismus Following Head and Neck Cancer

Elgohary, Hany M.; Eladl, Hadaya Mosaad; Soliman, Ashraf; Soliman, Elsadat Saad

doi:10.5535/arm.2018.42.6.846

Cited by 28 publications

(29 citation statements)

References 36 publications

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“…In the end, 11 eligible studies were included for systematic review. 18 - 28 Table 1 provides detailed characteristics of the included studies. All studies were published in English, used a randomized control design, and reported the effect of interventions to improve trismus following HNC treatment.…”

Section: Resultsmentioning

confidence: 99%

Interventions for Trismus in Head and Neck Cancer Patients: A Systematic Review of Randomized Controlled Trials

et al. 2021

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Background: Current treatment for head and neck cancers (HNCs) have led to an improved survival. However, the sequelae of cancer treatment often result in trismus, or reduced mouth opening. The purpose of this report is to identify interventional studies for trismus management in HNC patients. Methods: A search of PubMed, Embase, Cumulated Index to Nursing and Allied Health Literature, and the Cochrane Library was conducted in March 2020 for randomized controlled trials (RCTs) involving interventions for trismus for head and neck cancer within 10 years. Intervention could involve the use of an exercise regime, jaw rehabilitation device, technological device, medication or massage therapy. The primary outcome was the measurement of mouth opening. Results: Eleven RCTs involving a total of 685 patients with HNC were included. Six RCTs evaluated the effectiveness of a jaw mobilization device with exercises; there was no significant benefit of an exercise regime with a jaw mobilization device either initiated before, during or after treatment compared to no exercise. Two RCTs compared 2 intervention groups that involved exercises only, with 1 study assessing the benefit of weekly supervised physical therapy with gum chewing and another evaluating the benefit of immediate (1-2 days) versus delayed (7-10 days) initiation of exercise post-surgery; there was no significant difference between groups in either study. One RCT that recruited only patients with trismus demonstrated that an exercise regime in combination with low-level laser therapy or low-intensity ultrasound had superior results in mouth opening measurements compared to exercise alone. Two RCTs compared intervention groups with and without follow-up reminders; both studies showed a significant improvement in mouth opening measurements in groups with follow-up reminders. Conclusion: This systematic review did not convey a clear consensus as to optimal intervention for trismus in HNC patients. A variety of exercise regimens and jaw rehabilitation devices appear to have comparable effectiveness. However, efforts focused on increasing adherence to a particular intervention protocol may positively impact mouth opening measures in head and neck cancer patients. Also, low-level laser therapy and low-intensity ultrasound coupled with exercise may be beneficial for patients with trismus.

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Section: Resultsmentioning

confidence: 99%

Interventions for Trismus in Head and Neck Cancer Patients: A Systematic Review of Randomized Controlled Trials

et al. 2021

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“…The effect of lowlevel laser therapy in patients with TMD seems to relieve pain and improves functional outcomes [29] or dysfunctional TMJ [30]. And in comparing the effects of different methods, low intensity ultrasound and traditional exercise therapy were more effective that laser therapy reduced TMJ pain and trismus after oncologic surgery [31].…”

Section: Treatment Of Tmdmentioning

confidence: 99%

Nonsurgical Strategies for the Treatment of Temporomandibular Joint Disorders

Cabrera-Freitag¹,

Cobo²,

Muriel³

et al. 2019

Cartilage Tissue Engineering and Regeneration Techniques

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Temporomandibular disorders are common maxillofacial disturbs of different etiologies (traumatic, inflammatory, degenerative, or congenital) that course with pain and dysfunctions of the temporomandibular joint. The treatment of these disorders includes systematically administered drugs (especially nonsteroid antiinflammatory drugs and corticoids), physical therapies, and minimally invasive therapies that require intraarticular injections. These techniques are directed to clean or drain the articular cavity, to deliver intraarticularly drugs, biologically active compounds (as platelet-rich plasma), or to enhance lubrication (hyaluronic acid). Moreover, minimally invasive strategies are used in regenerative medicine for to deliver cells and stem cells, and nano-or micro-biomaterials. Surgery of temporomandibular disorders is only used in grave diseases that require arthrodesis or remotion of the temporomandibular joint. This review updates the nonsurgical therapeutic strategies to treat temporomandibular disorders, focusing the attention in the articular delivery or hyaluronic acid and platelet-rich plasma, two minimally invasive widely used at present.

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“…The modern treatment concept of TMDs involves different modalities that are most often applied simultaneously or successively. Therapeutic modalities include pharmacotherapy, physical therapy, occlusal, surgical, behavioral therapy and psychotherapy [2,3].…”

Section: Introductionmentioning

confidence: 99%

Low-level laser therapy effectiveness in patients with temporomandibular disorders

et al. 2021

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Introduction/Objective. Low-level laser therapy has been suggested as an alternative pain relief therapy in temporomandibular disorders patients. The aim of this study was to examine the effects of Low-level laser therapy on reducing pain intensity in temporomandibular disorders patients, compared to non-steroidal anti-inflammatory drugs. Methods. A total of 63 patients diagnosed with Research Diagnostic Criteria for Temporomandibular Disorders were divided into two groups. In the first group of 35 patients low-level laser therapy was applied three times a week, 15 treatment sessions during 5 weeks (Wavelength: 780 nm; Power density: 70 mW/cm2; Radiant energy: 4.2 J; Energy density: 4.2 J/cm2; Total treatment dose: 16.8 J/cm2;). The second group included 28 participants subjected to nonsteroidal anti-inflammatory drugs therapy (ibuprofen) during two weeks (first three days 3 ? 400 mg, remaining time 2 ? 400 mg per day). Pain was evaluated using 100 mm Visual Analog Scale, at the baseline, during therapy, two weeks and three months after treatments. Results. Statistically significant reduction of pain intensity was achieved both, in low-level laser therapy and in nonsteroidal anti-inflammatory drugs therapy groups and remained steady in the follow-up period of three months (p <0.01). Differences in Visual Analog Scale scores between observed groups were not statistically significant in each of the evaluation periods, (p = 0.375, p = 0.665, p = 0.52, respectively). Conclusion. The low-level laser therapy protocol applied in this research was efficient in reducing pain in temporomandibular disorders patients.

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Effects of Ultrasound, Laser and Exercises on Temporomandibular Joint Pain and Trismus Following Head and Neck Cancer

Cited by 28 publications

References 36 publications

Interventions for Trismus in Head and Neck Cancer Patients: A Systematic Review of Randomized Controlled Trials

Interventions for Trismus in Head and Neck Cancer Patients: A Systematic Review of Randomized Controlled Trials

Nonsurgical Strategies for the Treatment of Temporomandibular Joint Disorders

Low-level laser therapy effectiveness in patients with temporomandibular disorders

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