TMD
Conditions
Brief summary
Temporomandibular joint dysfunction (TMD) therapy remains an open challenge for modern dentistry. Usually physiotherapy is considered a reliable approach to treatment of TMD patients. Moreover, neuromuscular bites (orthotic) are able to reduce signs and symptoms of TMD. To our knowledge, no specific trials have been designed for the evaluation of the efficiency of physiotherapy vs neuromuscular bites in TMD patients. The aim of this trial is to evaluate the efficiency in term of cranial muscles electromyography (sEMG), mandibular kinetic (KNG) and subjective pain scores, of orthotic vs manual physiotherapy therapy compared to placebo.
Interventions
DEVICENeuromuscular Bite (orthotic/sub-lingual)
Bite is a device which simulates a set of properly positioned teeth
PROCEDUREMandibular Physiotherapy
Mandibular Stabilisation Exercises 1. Place knuckle of index finger between top and bottom teeth. 2. Remove it, keeping the teeth separated one-knuckle apart. 3. Apply gentle pressure to the to the jaw using your index finger/thumb as demonstrated in the pictures above.
OTHERPlacebo
No interventions.
Sponsors
University of L'Aquila
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Caregiver, Investigator, Outcomes Assessor)
Intervention model description
Testing Bite device A
Eligibility
Sex/Gender
FEMALE
Age
25 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
* myogenous TMD; * pain duration longer than 3 months; * presence of complete permanent dentition, with the possible exception of the third molars; * normal occlusion.
Exclusion criteria
Patients were excluded from the study if they met one or more of the following criteria: * presence of systemic or metabolic diseases; * eye diseases or visual defects; * history of local or general trauma; * neurological or psychiatric disorders; * muscular diseases; * cervical pain; * bruxism, as diagnosed by the presence of parafunctional facets and/or anamnesis of parafunctional tooth clenching and/or grinding; * pregnancy; * assumed use of anti-inflammatory, analgesic, anti-depressant, opioid, or myorelaxant - - drugs; * smoking; * fixed or removable prostheses; * fixed restorations that affected the occlusal surfaces; * and either previous or concurrent orthodontic or orthognathic treatment. For comparison with previous literature, the diagnosis of myofascial-type TMD was provided after clinical examination by a trained clinician according to group 1a and 1b of the Research Diagnostic Criteria for TMD (RDC/TMD), in a blinded manner
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Surface electromiography of cranial muscles (sEMG) | Average of 1 year | Evaluation of surface electromiography of cranial muscles (expressed in microvolts) |
| Mandibular kinesiography (KNG) | Average of 1 year | Evaluation of mandibular kinetics (expressed in millimeters/seconds) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain scale | 15 days | Evaluation of subjective pain perception by Visual Analog Scale (expressed in unit) |
Countries
Italy
Outcome results
None listed