Temporomandibular Disorder
Conditions
Brief summary
The aim of study is evaluate the effectiveness of physical therapy in of the treatment myogenic temporomandibular disorders. They will enrolled 100 patient which will be divided into two groups. The primary objective is evaluate the effectiveness of physiotherapy on pain (measured with the Visual Analogic Scale - VAS scale). The second objective is evaluate mandibular motion (by measuring the range of motion - ROM) and investigate the presence of psychosocial factors (using the Anxiety and Depression Scale - HADS questionnaire).
Detailed description
Randomized controlled clinical trial with randomization according to a multi-phase design. Phase 1 involves the enrollment of patients with DTMs based on diagnostic criteria. Phase 2 includes the algogenic, kinetic and gnathological evaluation of the enrolled patients. Phase 3 provides for the adoption of the criterion to one of the 2 treatment groups on the basis of the randomization list. The 2 therapeutic protocols are: * gnathological therapy (splint) associated with education and physiotherapy (test group); * gnathological therapy (splint) associated with education (control group). During the first visit the patient will be enlisted by evaluating the inclusion and exclusion criteria and signed the informed consent, he / she will be assigned a unique identification code. The code consists of a progressive number followed by the patient's initials (eg 01-F.R.). Subsequently, the patients will be randomized blinded and assigned to one of the two study groups. Randomization will be performed using random, computer-generated, centralized numbers placed in sealed opaque envelopes provided by the study coordinator. Both types of treatment will be performed by a single operator respectively.
Interventions
OTHERcontrol group
In the control group the patient will undergo gnathologic therapy for 6 months with neuromuscural splint every night for 3 months
OTHERtest group
In the test group the patient will undergo gnathologic therapy with neuromuscural splint every night for 3 months in association with physical therapy
Sponsors
Paolo Pillastrini
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* patients with myogenic temporomandibular disorders assessed with clinical examination as established by the DC / TMD1; * patients older than 18 years; * good knowledge of Italian language; * patients who have signed informed consent
Exclusion criteria
* edentulism which makes it impossible to apply gnathological bite; * patients with psychiatric problems; * patients included in other experimental protocols; * patients already undergoing surgical and / or radial therapy of the cervical and facial areas; * other temporomandibular disorders without a myogenic component; * treatment of the cervical and TMJ district in the previous 3 months; * history of drug abuse.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Evaluate the effectiveness of physical therapy using the VAS scale which allows to measure the varation of pain | Change from initial VAS at 3 and 6 months from the beginning of the treatment | The VAS measures the intensity of the pain that thethe patient perceived and it is represented by a 10 cm long scale with a score from 0 to 10. The VAS will be evaluated in 3 times: at rest; during the maximum buccal opening; during chewing |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| ROM (range of motion) | The measurement of the ROM occurs at the recruitment then at 3 and 6 months from the beginning of the treatment | The ROM measures the joint function. It provides the analytical and millimetric measurement of functional movements with a precision gauge positioned between the incisal edges of the upper and lower anterior groups. It should be noted: maximum buccal opening; deviation of the median line; left and right lateral movements; overjet and overbite. It should also be noted the extent of final elasticity (or end-feel test and its nature (elastic, painful, hard) |
Countries
Italy
Outcome results
None listed