Physiotherapy in the treatment of temporomandibular joint disorders: a comparative study of four treatment methods

Abstract

Temporomandibular joint pain dysfunction syndrome (TMJPDS) comprises of a constellation of signs and symptoms including joint tenderness and pain on function, restricted jaw movement, clicking, jaw locking and tenderness in the muscles of mastication. Headache may also be a feature. Physiotherapy is commonly employed in the treatment of this condition but there is little published material reporting the relative efficacy of the different types of treatment currently available. Further, no attempt seems to have been made to compare the costs of physiotherapy with other forms of treatment of this disorder such as occlusal splint therapy. This paper reports a comparative evaluation of four different physiotherapy treatments and placebo in the management of TMJPDS and comments on their cost benefit aspects compared with that of splint therapy. The four methods of physiotherapy tested were short-wave diathermy, megapulse, ultrasound and soft laser. There was no statistically significant difference in success rate between any of the four tested (range 70.4-77.7%) although each individually was significantly better than placebo treatment. The time of improvement appeared to vary between the four methods.

Phonophoresis in temporomandibular joint disorders: A clinical trial

“…It was also observed that the VAS score was significantly reduced immediately after the first visit in Group A and gradual reduction thereafter on the subsequent visits in both the groups. Similar observations of pain reduction were found in studies conducted by Shin and Choi [10] and Gray et al [11] in the management of TMDs. This may be attributed to phonophoresis technique, as ultrasound waves increase the kinetic energy of a drug molecule and increase circulation to the area, enhancing drug molecule to diffuse through the stratum corneum and achieve therapeutic drug concentration at the target thereby reducing inflammation and pain.…”

Comparison of three treatment options for painful temporomandibular joint clicking

“…This modality has been regularly employed in patients with TMD, in view of its analgesic and muscle-relaxing effect, giving positive results (16)(17)(18)(19). Therapeutic US has been used in the treatment of TMD because of its ability to increase the range of joint motion, improve tissue healing and collagen tissue extensibility, reduce muscle spasm, relieve pain, and resolve inflammation (15,20).…”

he effects of low level laser therapy on the management of chronic idiopathic orofacial pain: trigeminal neuralgia, temporomandibular disorders and burning mouth syndrome

“…Statistically significant reduction of pain in the laser group in relation to the placebo was observed in research by Gray et al 13 , Bertolucci and Grey 14 , Fikácková et al 15 , Mazzetto et al 16 , Öz S et al 17 , Çetiner et al 18 and Venezian et al 19 . Some of the studies reported both reduction of pain as well as a significant improvement in the range of mandibular movements and decreased tenderness of masticatory muscles [20][21][22] .…”