The Effect of Exercise on Range of Movement and Pain After Temporomandibular Joint Arthrocentesis

Baş, Burcu; Kazan, Dilara; Kütük, Nükhet; Gurbanov, Vügar

doi:10.1016/j.joms.2018.01.003

Cited by 10 publications

(9 citation statements)

References 19 publications

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“…The risk of bias scores for 13 RCTs 46–58 was obtained in the PEDro database, and for 3 RCTs 45,59,60 it was assessed manually. All included RCTs obtained 3 points or more.…”

Section: Resultsmentioning

confidence: 99%

“…Three hundred eighty-nine studies were screened for eligibility and 385 were excluded for not meeting the inclusion criteria (reasons in Figure 1). Finally, 16 studies [45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60] were included in this meta-analysis. The PRISMA flow chart (Figure 1) displays the study selection process.…”

Section: Resultsmentioning

confidence: 99%

“…The studies included were carried out between 2001 and 2021 in Europe, Asia, America and Australia. These studies provided data from 812 participants (29.01 ± 7.64 years old and 77% female) with different temporomandibular disorders, being the most frequent temporomandibular disc displacement with or without reduction 45,[50][51][52][54][55][56]59 and orofacial pain. 49,53,58,60 The experimental group was comprised of 416 participants (29.01 ± 7.64 years old and 77% female) who performed temporomandibular exercise therapy as unique therapy or combined with others (splints, physiotherapy or counselling education).…”

Section: Resultsmentioning

confidence: 99%

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Exercise therapy improves pain and mouth opening in temporomandibular disorders: A systematic review with meta-analysis

Idáñez-Robles¹,

Obrero‐Gaitán

Lomas‐Vega

et al. 2022

Clin Rehabil

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Objective To analyse the effectiveness of exercise therapy in improving pain and active or passive maximum mouth opening in patients with temporomandibular disorders. Data sources PubMed Medline, Web of Science, Scopus, CINAHL Complete and Physiotherapy Evidence Database, until April 2022, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Review methods We included randomized controlled trials evaluating the effect of exercise therapy on pain and on active and passive maximum mouth opening in patients with temporomandibular disorders. Effect size was calculated using Cohen's standardized mean difference (SMD) and their 95% confidence interval (95% CI) in a random-effects model. Results A total of 16 studies with 812 participants were included. Exercise therapy is effective in reducing pain (SMD: −0.58; 95% CI: −1.01 to −0.12) and increasing the pain pressure threshold (SMD: 0.45; 95% CI: 0.14–0.76), active and passive maximum mouth opening (SMD: 0.43; 95% CI: 0.14–0.71 and SMD: 0.4; 95% CI: 0.06–0.75, respectively). Subgroup analyses showed more effect of exercise therapy more splints versus splints on pain (SMD: −0.5; 95% CI: −0.73 to −0.26), active and passive maximum mouth opening (SMD: 1.14; 95% CI: 0.22–2.07 and SMD: 0.56; 95% CI: 0.06–1.06, respectively). On pain pressure threshold, exercise therapy was better than physiotherapy approach (manual therapy and electrotherapy) (SMD: 0.48; 95% CI: 0.09–0.87). Conclusions Therapeutic exercise is an effective therapy to reduce pain and increase pain pressure threshold and active and passive maximum mouth opening in patients with temporomandibular disorders.

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“…The risk of bias scores for 13 RCTs 46–58 was obtained in the PEDro database, and for 3 RCTs 45,59,60 it was assessed manually. All included RCTs obtained 3 points or more.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Exercise therapy improves pain and mouth opening in temporomandibular disorders: A systematic review with meta-analysis

Idáñez-Robles¹,

Obrero‐Gaitán

Lomas‐Vega

et al. 2022

Clin Rehabil

View full text Add to dashboard Cite

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“…It was also important that well-defined physical examination techniques such as the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) (36) or other validated techniques were used to identify the presence or absence of signs and symptoms that defined the patient sample. In our review of 31 published RCTs, some studies had no inclusion or exclusion criteria (2,14,33) or used a diagnosis of disk displacement with or without reduction as the inclusion criteria without reporting the exclusion of other pain sources such as masticatory muscle myalgia (3)(4)(5)(7)(8)(9)(10)(11)15,17,18,(20)(21)(22)24,(26)(27)(28)(29)(30)(31)(32). Only a few RCTs confirmed the source of pain was from TMJ innervated structures by either the use of a local anesthetic to anesthetize the auriculotemporal nerve and eliminating the TMJ pain (6) or by selectively loading the TMJ by contralateral biting and duplicating the intracapsular source of pain within the joint (19).…”

Section: Identifying the Appropriate Patient To Test Tmj Arthrocentesis Efficacymentioning

confidence: 99%

Temporomandibular joint arthrocentesis: an evidence-based review

Dolwick¹,

Widmer²

2020

Front Oral Maxillofac Med

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Temporomandibular joint (TMJ) intracapsular pain can sometimes persist after pursuing reversible techniques. TMJ pain reduction may require a more focused treatment approach such as arthrocentesis to remove intracapsular inflammatory mediators. Evidence of efficacy for treating TMJ pain and mandibular mobility using TMJ arthrocentesis is available from a small number of high-quality evidence randomized controlled trials (RCTs). However, there still remains a lack of high-quality evidence to test the efficacy of various supplements that have been proposed to further enhance the outcomes after arthrocentesis. The purpose of this review was to examine published RCTs to determine the efficacy of TMJ arthrocentesis alone and with supplementation by steroids, hyaluronic acid and platelet-rich plasma growth factors. Thirty-one RCTs were identified from the literature with most of the studies having low to medium quality evidence. Most of the RCTs suffered from a lack of controlling experimental bias, lack of inclusion and exclusion criteria, lack of pain source validation, lack of stratification by sex and inclusion of bilateral TMJ arthrocentesis procedures that can confound the interpretation of the results of the procedure. Some RCTs were single or double blind studies, but the majority did not use a blinded experimental design.Low to medium quality evidence RCTs that focused on a comparison of TMJ arthrocentesis alone to postarthrocentesis supplementation found no differences in resting pain intensity or mandibular mobility.However, one high-quality evidence RCT that evaluated steroid supplementation (triamcinolone acetonide) found a significant improvement and normalization of chewing pain and the normalization of mandibular mobility at 12 weeks post-arthrocentesis compared to the control group. Hyaluronic acid has been evaluated by medium quality evidence RCTs and these studies did not find differences between supplementation and control groups for pain or mandibular mobility. Finally, platelet-rich plasma has been used as a supplement and one study with medium quality evidence found significant differences between groups for pain, mandibular mobility and chewing efficiency. The paucity of high-quality evidence RCTs has not allowed a consensus for the efficacy of TMJ post-arthrocentesis supplements and further studies are required to guide the practicing clinician on their use.

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“…Recent studies have investigated the factors that determine the effectiveness of arthrocentesis, such as the needle technique, adjunctive treatment and lavage volume [ 21 , 22 , 23 ]. In particular, there is no consensus on the lavage volume in arthrocentesis, and the commonly adopted volume ranges from 50 mL to 300 mL.…”

Section: Introductionmentioning

confidence: 99%

Lavage Volume of Arthrocentesis in the Management of Temporomandibular Disorders: A Systematic Review and Meta-Analysis

et al. 2022

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The aim of this study was to investigate the most effective lavage volume of arthrocentesis in the management of temporomandibular disorders. A comprehensive electronic search, based on the PRISMA guidelines, was performed, which included a computer search with specific keywords, a reference list search and a manual search. The inclusion criteria were the following: a randomized controlled trial, at least 20 subjects who underwent arthrocentesis, mention of the irrigation materials used for the arthrocentesis, mention of the irrigation volumes used for the arthrocentesis, MMO and pain measured as VAS or NRS, were reported as outcome figures, mention of a specific diagnosis or signs and symptoms, and inclusion of the data on the MMO or VAS/NRS at 6-month follow-up. Sixteen publications were enrolled in the meta-analysis, comparing arthrocentesis with a lavage volume <150 mL and arthrocentesis with a lavage volume ≥150 mL, in the efficacy of the improvement in the mouth opening and pain reduction. The results revealed the group with a lavage volume <150 mL had a greater improvement in the mouth opening and pain reduction. However, results are to be interpreted with caution, due to the paucity of the randomized controlled literature and other confounding factors. Further high-quality studies are required to provide a better conclusion to the treatment outcomes of the different lavage volumes.

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The Effect of Exercise on Range of Movement and Pain After Temporomandibular Joint Arthrocentesis

Cited by 10 publications

References 19 publications

Exercise therapy improves pain and mouth opening in temporomandibular disorders: A systematic review with meta-analysis

Exercise therapy improves pain and mouth opening in temporomandibular disorders: A systematic review with meta-analysis

Temporomandibular joint arthrocentesis: an evidence-based review

Lavage Volume of Arthrocentesis in the Management of Temporomandibular Disorders: A Systematic Review and Meta-Analysis

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