Short-term effect of two therapeutic methods on myofascial pain and dysfunction of the masticatory system

doi:10.1016/0022-3913(88)90223-5

The Journal of Prosthetic Dentistry

Volume 60, Issue 5, November 1988, Pages 606-610

https://doi.org/10.1016/0022-3913(88)90223-5 Get rights and content

Abstract

In conclusion, a short-term intervention with IS therapy was found to result in a substantial decrease in facial pain for most of the subjects treated. Generally, groups were not found to be significantly different in respect to palpation pain change from session 1 to session 2. Neither therapy significantly altered the range of mouth opening. EMG findings were variable but suggest that RI therapy may alter muscle myoelectric activity. From these findings, ice and stretch of the masticatory and neck musculature would appear to be a good short-term adjunctive therapy to control pain with little apparent risk of negative effects.

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Exercise, especially combined stretching and strengthening exercise, reduces myofascial pain: a systematic review
2017, Journal of Physiotherapy
Citation Excerpt :
Four studies (50%) reported symptom duration of > 3 months,27,29,31,32 one study (12%) divided symptom duration into ≤ or > than 6 months28 and three studies (38%) did not indicate the symptom duration.30,33,34 Six studies27,28,30,31,33,34 reported two experimental groups performing exercise; only data from the group that performed exercise alone were eligible. Six studies27–29,31,32,34 compared exercise to minimal or no intervention (ie, support and encouragement or no treatment), and two studies30,33 compared exercise with other intervention (ie, electrotherapy or dry needling).
Question: Among people with myofascial pain, does exercise reduce the intensity of the pain and disability? Design: Systematic review of randomised and quasi-randomised controlled trials. Participants: People with myofascial pain of any duration. Intervention: Exercise versus minimal or no intervention and exercise versus other intervention. Outcome measures: Pain intensity and disability. Results: Eight studies involving 255 participants were included. Pooled estimates from six studies showed statistically significant effects of exercise when compared with minimal or no intervention (support and encouragement or no treatment) on pain intensity at short-term follow-up. The weighted mean difference in pain intensity due to exercise was –1.2 points (95% CI –2.3 to –0.1) on a 0 to 10 scale. Pooled estimates from two studies showed a non-significant effect of exercise when compared with other interventions (electrotherapy or dry needling) on pain intensity at short-term follow-up. The weighted mean difference in pain intensity due to exercise instead of other therapies was 0.4 points (95% CI –0.3 to 1.1) on a 0 to 10 scale. Individual studies reported no significant effects of exercise on disability compared with minimal intervention (–0.4, 95% CI –1.3 to 0.5) and other interventions (0.0, 95% CI –0.8 to 0.8) at short-term follow-up. Sensitivity analysis suggested that combining stretching and strengthening achieves greater short-term effects on pain intensity compared with minimal or no intervention (–2.3, 95% CI –4.1 to –0.5). Conclusion: Evidence from a limited number of trials indicates that exercise has positive small-to-moderate effects on pain intensity at short-term follow-up in people with myofascial pain. A combination of stretching and strengthening exercises seems to achieve greater effects. These estimates may change with future high-quality studies. [Mata Diz JB, de Souza JRLM, Leopoldino AAO, Oliveira VC (2016) Exercise, especially combined stretching and strengthening exercise, reduces myofascial pain: a systematic review. Journal of Physiotherapy 63: 17–22]
Home Exercise Program for the Temporomandibular Patients
2016, Pathology and Intervention in Musculoskeletal Rehabilitation
Treatment of anterior open bite and multiple missing teeth with lingual fixed appliances, double jaw surgery, and dental implants
2013, American Journal of Orthodontics and Dentofacial Orthopedics
The treatment of adult patients with severe anterior open bite frequently requires orthognathic surgery, especially when the chin is retruded severely. If a patient has multiple missing posterior teeth, it is difficult to control the occlusal plane because it is challenging to obtain anchorage during orthodontic treatment. We report on a 25-year-old woman who had a skeletal Class II malocclusion, severe anterior open bite, vertical maxillary asymmetry, and severe dental caries on her molars. There was no posterior occlusal contact between the maxillary and mandibular molars since 5 of her molars had to be extracted because of severe caries. Lingual fixed appliances and double jaw surgery were performed to treat her skeletal and dental problems, and dental implants helped restore her masticatory function. Pretreatment, posttreatment, and retention photographs demonstrate effective, esthetically pleasing, and stable treatment results.
Temporomandibular Disorders
2013, Women and Health
Intraoral myofascial therapy for chronic myogenous temporomandibular disorder: A randomized controlled trial
2012, Journal of Manipulative and Physiological Therapeutics
Citation Excerpt :
The results of this study suggest that these techniques can be used safely and be well tolerated by patients. The lack of any adverse reactions in the participants is probably caused by both the simplicity and relative gentleness of the techniques and is typical of other myofascial release studies.96,99-101,116,117 The treatment groups yielded positive short- and intermediate-term outcomes, which is in line with outcomes of studies investigating manual and myofascial treatment for other regions of the body.97,99,117-119
Studies investigating the efficacy of intraoral myofascial therapies (IMTs) for chronic temporomandibular disorder (TMD) are rare. The present study was an expansion of a previously published pilot study that investigated whether chiropractic IMT and the addition of education and self-care were superior to no-treatment or IMT alone for 5 outcome measures—interincisal opening range, jaw pain at rest, jaw pain upon opening, jaw pain upon clenching, and global reporting of change—over the course of 1 year.
Ninety-three participants with myogenous TMD between the ages of 18 and 50 years experiencing chronic jaw pain of longer than 3 months in duration were recruited for the study. Successful applicants were randomized into 1 of 3 groups: (1) IMT consisting of 2 treatment interventions per week for 5 weeks, (2) IMT plus education and “self-care” exercises (IMTESC), and (3) wait-list control. The main outcome measures were used. Range of motion findings were measured by vernier callipers in millimeters, and pain scores were quantified using an 11-point self-reported graded chronic pain scale. Global reporting of change was a 7-point self-reported scale, balanced positively and negatively around a zero midpoint.
There were statistically significant differences in resting, opening and clenching pain, opening scores, and global reporting of change (P < .05) in both treatment groups compared with the controls at 6 months and 1 year. There were also significant differences between the 2 treatment groups at 1 year.
The study suggests that both chiropractic IMT and IMTESC were superior to no-treatment of chronic myogenous TMD over the course of 1 year, with IMTESC also being superior to IMT at 1 year.
The efficacy of traditional, low-cost and nonsplint therapies for temporomandibular disorder: A randomized controlled trial
2006, Journal of the American Dental Association
Treatment recommendations for patients with painful temporomandibular disorders (TMDs) range from conservative treatments such as physiotherapy to aggressive and irreversible treatments such as restorative reconstruction and joint surgery.
The authors randomized 200 subjects diagnosed with TMD into three groups: usual conservative, dentist-prescribed self-care treatment without any intraoral splint appliance (UT); UT plus a conventional flat-plane hard acrylic splint (HS); and UT plus a soft vinyl (a low-cost athletic mouth guard) splint (SS). Subjects completed questionnaires and clinical examinations at three, six and 12 months.
The authors observed no significant differences among the groups in TMD-related pain levels or other common signs and symptoms of TMD at baseline (BL) or at any follow-up. The changes from BL were comparable for all three groups. The authors did not note any significant differences at any follow-up for compliance with study protocols or for occurrences of adverse effects from either splint type. For HS versus SS, there were significant differences in rates of splint use, but these differences were not accompanied by differences in either self-reported symptoms or in clinical findings.
All patients improved over time, and traditional splint therapy offered no benefit over the SS splint therapy. Neither splint therapy provided a greater benefit than did self-care treatment without splint therapy.
These findings suggest that clinicians who treat patients with TMD should consider prescribing low-cost nonsplint self-care therapy for most patients.

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^*: Senior Research Fellow, Department of Anesthesia, Pain Center; Auxillary Faculty, Department of Oral Medicine, University of Washington, School of Dentistry.

^**: Lecturer, Department of Oral Medicine, University of Washington, School of Dentistry.

^***: Chairperson, Department of Oral Medicine, University of Washington, School of Dentistry.

View full text

Short-term effect of two therapeutic methods on myofascial pain and dysfunction of the masticatory system

Abstract

Am J Orthod

J Prosthet Dent

Oral Surg

J Prosthet Dent

Int J Oral Surg

J Am Dent Assoc

J Am Dent Assoc

J Am Dent Assoc

Pain

J Am Dent Assoc

Behav Res Ther

Behav Ther

Oral Surg

J Prosthet Dent

Pain associated with the temporomandibular joint

J Am Dent Assoc

Clinical management of temporomandibular disorders

Therapeutic exercises

Overview of physical therapy alternative for reducing muscle contracture

Phys Ther

Muscular aspects of oral dysfunction

Physiatric approach to chronic pain