Phonophoresis in temporomandibular joint disorders: A clinical trial

Abstract

Background and Objective: Temporomandibular joint disorders (TMDs) are identified as a major cause of non-dental pain in the orofacial region. An effective drug delivery into this complex joint can result in a good prognosis. Phonophoresis is a novel phenomenon that exponentially increases the absorption of topical pharmacological compounds and achieves effective therapeutic drug concentration at the target site. Hence, this study is designed to assess the feasibility and effectiveness of aceclofenac gel phonophoresis in the management of TMDs. Methods: Selected 60 patients were randomly divided into two equal groups. Group A were treated with aceclofenac gel phonophoresis and Group B with that of its topical application for 15 days. The scores of visual analog scale (VAS), maximum mouth opening, lateral and protrusive excursion, Helkimo anamnestic and clinical dysfunction index, erythrocyte sedimentation rate, and C-reactive protein were evaluated at baseline and 15 days after treatment. Results: Statistically significant increase in mean maximum mouth opening, lateral excursion and a significant reduction in scores of VAS, Helkimo anamnestic, and clinical dysfunction index were observed post-treatment in Group A as compared to Group B. Conclusions: Aceclofenac gel phonophoresis is feasible and effective in reduction of signs and symptoms of TMDs.

Effect of Diclofenac Gel Phonophoresis on Temporomandibular Joint Disorders: A Prospective Quasi-Experimental Study

“…Deep heat (thermal US effect) causes local vasodilatation, which increases cell permeability and pain relief. Moreover, acoustic pressure waves (non-thermal US effect) causes the cells to oscillate at high speed (vibration) and to disrupt the membrane favoring the diffusion of the anti-inflammatory drug (diclofenac) (16). We postulate that the anti-inflammatory effect of diclofenac plus the biological effect of US (19) are capable of ameliorating TMD symptoms, a fact that has been demonstrated in this study.…”

“…The only known study that evaluated phonophoresis with aceclofenac gel on TMD used a protocol similar to ours (1 MHz/0.8 -1.5 W/cm 2 /10 minutes). In that study, a frequency of 1 MHz showed higher transport than 3 MHz on topical gel application (16). In the referred study, their similar protocol decreased pain both in males (from 7 to 2.1 points) and females (from 7.85 to 3.6 points) and improved mouth opening both in males (from 33.5 ± 8.4 to 39.7 ± 7.8 mm) and in females (from 29.2 ± 7.3 to 34.3 ± 8.8 mm) (16).…”

“…Phonophoresis is a physical therapy modality that favors the absorption of topical drugs and increases the concentration of the drug at the target region (16). Previous reviews have suggested that an effective drug into the TMJ could result in alleviating TMD symptoms.…”

“…This technique is effective for the delivery of antiinflammatory drugs for knee and other articulations (15); however, its use for the management of TMD is limited or absent. There is only one study that reported the effect of aceclofenac on TMD (16).…”

Effects of a program consisting of strain/counterstrain technique, phonophoresis, heat therapy, and stretching in patients with temporomandibular joint dysfunction

“…[27] When a medicine is administered using phonophoresis, it is transmitted to deep tissues using US energy, and the clinical outcome is related to the drug pharmacological activity. [26] Vijayalakshmi et al [28] used aceclofenac gel phonophoresis on TMD and concluded that it is effective and feasible in reducing symptoms of TMD.…”