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Zhu Y, Xu J, Zhang J, Wan Y, He Y, Lei J, Zhang Y, Yang C, Yang Y. Exercise therapy in postoperative patients with temporomandibular joint internal derangement: A systematic review. J Oral Rehabil 2024. [PMID: 38873746 DOI: 10.1111/joor.13780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 05/16/2024] [Accepted: 05/31/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVE Postoperative patients with temporomandibular joint internal derangement (ID) often have problems such as limited mouth opening and pain. Exercise therapy can be advantageous for improving the recovery of patients following surgery. However, there is continuing discussion on the precise aspects of the exercise program, including the optimal timing, length, intensity, and use of assistive equipment. Hence, this study aimed to incorporate pre-existing exercise treatment regimens and investigate their impact. METHODS Publications that detailed the clinical treatment of patients with temporomandibular joint ID who received postoperative exercise therapy interventions were included. Nine databases were searched until October 1st, 2023. The JBI critical appraisal tools were used to assess the methodological quality of the included studies. RESULTS Five studies were finally included for subsequent analysis; two were randomised controlled studies, and three were quasi-experimental. Exercises suitable for such patients encompass vertical, transverse, and horizontal stretching, among which vertical stretch can be divided into active and passive movements. The start time ranged from the first to the fifth week after surgery, with a duration of 1-6 months. Although the data in the studies could not be integrated and further analysed, preliminary results showed that maximum mouth opening and pain in patients improved significantly. The therapeutic effect of combining three exercise methods was best and was related to patient compliance. CONCLUSION Exercise therapy positively affects postoperative rehabilitation in patients with temporomandibular joint ID. It is proposed that targeted, comprehensive studies be conducted to provide a basis for designing more sophisticated exercise therapy regimens and further confirm its curative effect.
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Affiliation(s)
- Yongkang Zhu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology and National Center of Stomatology, Beijing, People's Republic of China
| | - Jiaqi Xu
- Nursing Department, Peking University Third Hospital, Beijing, People's Republic of China
| | - Jing Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology and National Center of Stomatology, Beijing, People's Republic of China
| | - Yifan Wan
- Franklin and Marshall College, Lancaster, Pennsylvania, USA
| | - Yang He
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology and National Center of Stomatology, Beijing, People's Republic of China
| | - Jie Lei
- Center for TMD & Orofacial Pain, Department of Oral & Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology, Beijing, People's Republic of China
| | - Yi Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology and National Center of Stomatology, Beijing, People's Republic of China
| | - Chengfengyi Yang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology and National Center of Stomatology, Beijing, People's Republic of China
| | - Yue Yang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology and National Center of Stomatology, Beijing, People's Republic of China
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Pehlivan Tekin G, Yakut Y. Effectiveness of a home exercise program when added to a conventional physiotherapy program in patients with temporomandibular disorders: A comparative study. Cranio 2024:1-12. [PMID: 38852060 DOI: 10.1080/08869634.2024.2360370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2024]
Abstract
OBJECTIVE This study aimed to investigate the effect of a home exercise program on pain and quality of life (QoL) in TMD. METHODS Twenty patients were included in the study. The Group A received both a home exercise program and a physiotherapy program, while only a physiotherapy program was given to the Group B. Pain was measured using the Visual Analogue Scale (VAS) and QoL using the Short-Form 36 (SF-36). RESULTS Pain decreased in both groups (p < 0.05). Among the SF-36 domains, bodily pain, vitality and social functioning scores improved in the Group A, while only the bodily pain parameter improved in the Group B (p < 0.05). On between-group comparison, the positive effect on pain and quality of life was greater in the Group A (p < 0.05). CONCLUSION The addition of a home exercise program to the conventional physiotherapy program provided greater improvement in pain and QoL in patients with TMD.
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Affiliation(s)
- Gül Pehlivan Tekin
- Physiotherapy Programme, Niğde Ömer Halisdemir University, Niğde, Turkey
| | - Yavuz Yakut
- Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Hasan Kalyoncu University, Gaziantep, Turkey
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Marlière DAA, Vicentin Calori MJA, Medeiros YDL, Santiago RC, Strujak G, Asprino L. Clinical outcomes of the discopexy using suture anchors for repositioning disc displacement in temporomandibular joints: Systematic review and meta-analysis. J Craniomaxillofac Surg 2023; 51:475-484. [PMID: 37517977 DOI: 10.1016/j.jcms.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 04/05/2023] [Accepted: 06/25/2023] [Indexed: 08/01/2023] Open
Abstract
The present study evaluated the literature regarding the clinical outcomes after discopexy using suture bone anchors for repositioning disc displacement. A systematic review was conducted according to the PRISMA statement and applied for the PROSPERO platform. The database searches were performed in the PubMed, Scopus, Web of Science, EMBASE, The Cochrane Library, and LILACS for full articles published from no restrictions of the initial period time to April 2022. Selection criteria included clinical studies in humans comparing maximal inter-incisal opening (MIO), pain by visual analogue scale (VAS), and protrusive and lateral excursions before and after discopexy. The screening process was performed by two independent reviewers, and if they did not agree with each other, a third reviewer was consulted before proceeding. The meta-analysis was carried out by Comprehensive Meta-Analysis software. Eleven studies met the inclusion criteria. A total of 327 patients were diagnosed with disc displacement, and 142 patients were refractory to conservative and minimally surgical therapies. Preauricular and endaural approaches were performed to place suture bone anchors on the posterior area of the condyle. A significant difference was found in MIO, which ranged from 15.5 mm pre-opeatively to 41.6 mm post-operatively (p = 0.001). Pain scores using the VAS ranged from 7.42 to 0.28 indicating improvement post-operatively (p = 0.001). Mandibular excursions were underestimated. The available results have shown that discopexy using suture anchors seemed to decrease pain and improve mouth opening. Clinical studies are required in a larger sample and lower variability of follow-up time to predict actual benefits.
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Affiliation(s)
- Daniel Amaral Alves Marlière
- Division of Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil; Division of Oral and Maxillofacial Surgery, University Hospital of Federal University of Juiz de Fora, Juiz de Fora, Brazil.
| | | | | | - Rodrigo César Santiago
- Division of Oral and Maxillofacial Surgery, University Hospital of Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | | | - Luciana Asprino
- Division of Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
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Brandão RDAFS, Mendes CMC, Lopes TDS, Brandão Filho RA, Sena EPD. Neurophysiological aspects of isotonic exercises in temporomandibular joint dysfunction syndrome. Codas 2021; 33:e20190218. [PMID: 34008769 DOI: 10.1590/2317-1782/20202019218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 06/03/2020] [Indexed: 11/21/2022] Open
Abstract
PURPOSE The aim of the study was to investigate the electroneurophysiological aspects of volunteers with temporomandibular disorders before and after performing isotonic exercises for pain relief and self-care guidelines. METHODS The study was a parallel controlled randomized controlled trial under protocol 1,680,920. The inclusion criteria were age between 18 and 60 years, muscle temporomandibular dysfunction with or without limitation of mouth opening and self-reported pain with scores between 4 and 10. The individuals were randomized into experimental group and control. Twenty-three volunteers participated in the study, most of then were female. Control group had 11 and experimental group 12 individuals. Dropouts occurred in both groups, two in the experimental group and three in the control group. Since there were an intergroup imbalance the power density was analysed just in experimental group. Electroencephalographic recording was performed before and after the interventions, using the 32-channel apparatus, with sample frequency of 600 Hz and impedance of 5 kΩ. The data were processed through the MATLAB computer program. The individual records filtered off-line, using bandpass between 0.5 and 50 Hz. Epochs of 1,710 ms were created and the calculation of the absolute power density calculated by means of the fast Fourier transform. The statistical approach was inferential and quantitative. RESULTS The alpha power density analyzed presented a difference, but not significant, when compared in the two moments. CONCLUSION According to this study, isotonic exercises performed to reduce pain provided a small increase in alpha power density in the left temporal, parietal and occipital regions.
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Affiliation(s)
- Renata de Assis Fonseca Santos Brandão
- Programa de Pós-graduação de Processos Interativo de Órgãos e Sistemas, Instituto de Ciências da Saúde, Universidade Federal da Bahia - UFBA - Salvador (BA), Brasil.,Departamento de Ciências da Vida, Universidade do Estado da Bahia - UNEB - Salvador (BA), Brasil
| | - Carlos Maurício Cardeal Mendes
- Programa de Pós-graduação de Processos Interativo de Órgãos e Sistemas, Instituto de Ciências da Saúde, Universidade Federal da Bahia - UFBA - Salvador (BA), Brasil
| | - Tiago da Silva Lopes
- Programa de Pós-graduação de Medicina e Saúde, Universidade Federal da Bahia - UFBA - Salvador (BA), Brasil.,Faculdade Adventista da Bahia - Cachoeira (BA), Brasil
| | | | - Eduardo Pondé de Sena
- Programa de Pós-graduação de Processos Interativo de Órgãos e Sistemas, Departamento de Farmacologia e Fisiologia, Instituto de Ciências da Saúde, Universidade Federal da Bahia - UFBA - Salvador (BA), Brasil
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Effectiveness of disk repositioning and suturing comparing open-joint versus arthroscopic techniques: a systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:506-513. [PMID: 34034997 DOI: 10.1016/j.oooo.2021.02.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 02/03/2021] [Accepted: 02/21/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of this study was to present a systematic review of the effectiveness of discopexy in managing internal derangement of the temporomandibular joint (TMJ). STUDY DESIGN We searched MEDLINE through PubMed, SCOPUS, Web of Science, and Cochrane Central Register of Controlled Trials and grey literature accessed through Google Scholar, Openthesis, and hand-searching from inception to July 2020. The search strategy yielded 363 potentially relevant studies. After screening titles and abstracts, 41 full-text articles were assessed for eligibility and 7 studies were included in the meta-analysis. RESULTS There was an overall decrease in visual analog scale (VAS) pain score of 4.59 cm (95% confidence interval [CI], 2.03-7.16; P < .001) during the follow-up time and an overall increase of 10 mm (95% CI, 6.93-13.01; P < .001) in mouth opening after TMJ surgeries with discopexy. CONCLUSIONS The available evidence showed an overall decrease in VAS pain score and an improvement in mouth opening after TMJ surgeries with discopexy. Changes in maximal interincisal opening were greater after arthroscopic disk repositioning compared to open-joint procedure.
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Rodrigues-de-Souza DP, Paz-Vega J, Fernández-de-las-Peñas C, Cleland JA, Alburquerque-Sendín F. Is Irritable Bowel Syndrome Considered in Clinical Trials on Physical Therapy Applied to Patients with Temporo-Mandibular Disorders? A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228533. [PMID: 33213056 PMCID: PMC7698821 DOI: 10.3390/ijerph17228533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/09/2020] [Accepted: 11/16/2020] [Indexed: 02/06/2023]
Abstract
The aim of the current scoping review was to identify if the presence of irritable bowel syndrome was included as eligibility criteria of participants included in clinical trials investigating the effects of physical therapy in individuals with temporomandibular pain disorders (TMDs). A systematic electronic literature search in the Web of Science database was conducted. Scientifically relevant, randomized clinical trials (those cited in other studies at least 5 times, or clinical trials published in high-impact journals, i.e., first and second quartiles (Q1-Q2) of any category of the Journal Citation Report (JCR)) evaluating the effects of any physical therapy intervention in patients with TMDs were included. The Physiotherapy Evidence Database (PEDro) scale was used to evaluate the methodological quality of the selected trials. Authors affiliated to a clinical or non-clinical institution, total number of citations, objective, sex/gender, age, and eligibility criteria in each article were extracted and analyzed independently by two authors. From a total of 98 identified articles, 12 and 19 clinical trials were included according to the journal citation criterion or JCR criterion, respectively. After removing duplicates, a total of 23 trials were included. The PEDro score ranged from 4 to 8 (mean: 6.26, SD: 1.48). Based on the eligibility criteria of the trials systematically reviewed, none considered the presence of comorbid irritable bowel syndrome in patients with TMDs. The comorbidity between TMDs and irritable bowel syndrome is not considered within the eligibility criteria of participants in highly cited clinical trials, or published in a high-impact journal, investigating the effects of physical therapy in TMDs.
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Affiliation(s)
- Daiana P. Rodrigues-de-Souza
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (D.P.R.-d.-S.); (J.P.-V.); (F.A.-S.)
| | - Javier Paz-Vega
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (D.P.R.-d.-S.); (J.P.-V.); (F.A.-S.)
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Madrid, Spain
- Correspondence: ; Tel.: +34-914-888-884
| | - Joshua A. Cleland
- Doctor of Physical Therapy Program, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02155, USA;
| | - Francisco Alburquerque-Sendín
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (D.P.R.-d.-S.); (J.P.-V.); (F.A.-S.)
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
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La Touche R, Boo-Mallo T, Zarzosa-Rodríguez J, Paris-Alemany A, Cuenca-Martínez F, Suso-Martí L. Manual therapy and exercise in temporomandibular joint disc displacement without reduction. A systematic review. Cranio 2020; 40:440-450. [PMID: 32589520 DOI: 10.1080/08869634.2020.1776529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this systematic review was to analyze the effectiveness of exercise and manual therapy interventions in patients with disc displacement without reduction. METHOD The authors performed a systematic review of Medline, EMBASE, PEDro, CINAHL, and Google Scholar databases. Two independent reviewers conducted the eligibility and quality assessment of studies. Interventions based on exercise and manual therapy regarding pain intensity and maximum mouth opening as primary outcomes were examined. RESULTS Ten articles were included, according to the inclusion criteria. Most of the interventions showed statistically significant improvements in the primary outcomes. CONCLUSION Results show that interventions based on therapeutic exercise or manual therapy may be beneficial and play a role in the treatment of disc displacement without reduction. Limited evidence suggests that exercise significantly improves mouth opening in comparison to splints. Due to the heterogeneity of the included studies, these results should be interpreted with caution.
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Affiliation(s)
- Roy La Touche
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Autonomous University of Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Autonomous University of Madrid, Madrid, Spain.,Neuroscience and Craniofacial Pain Institute, (INDCRAN), Madrid, Spain
| | - Tania Boo-Mallo
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Autonomous University of Madrid, Madrid, Spain
| | - Joseba Zarzosa-Rodríguez
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Autonomous University of Madrid, Madrid, Spain
| | - Alba Paris-Alemany
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Autonomous University of Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Autonomous University of Madrid, Madrid, Spain.,Neuroscience and Craniofacial Pain Institute, (INDCRAN), Madrid, Spain
| | - Ferran Cuenca-Martínez
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Autonomous University of Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Autonomous University of Madrid, Madrid, Spain
| | - Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Autonomous University of Madrid, Madrid, Spain.,Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
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Brandão RDAFS, Mendes CMC, Brandão Filho RA, De Sena EP. Isotonic exercises and relaxing techniques in individuals with temporomandibular dysfunction. Cranio 2020; 40:199-206. [PMID: 31900091 DOI: 10.1080/08869634.2019.1708607] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: The present study aimed to compare the clinical characteristics of volunteers with temporomandibular dysfunction before and after performing exercises with those of volunteers who only followed self-care guidelines.Methods: A parallel randomized controlled trial was performed. Individuals included underwent the intervention twice a week for one month, while the control group only followed self-care guidelines.Results: Twenty-three volunteers participated; however, during the study, four dropped out. At the end of the study, the degree of depression decreased in the volunteers in the intervention group.Conclusion: The level of pain decreased, but the improvement was not statistically significant and, therefore, could not be attributed to the intervention. It can be concluded that the strategies used to reduce pain in this study were not sufficient for clinical improvement in volunteers with temporomandibular dysfunction.
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Affiliation(s)
- Renata De Assis Fonseca Santos Brandão
- Postgraduate Studies in Interactive Processes of Organs and Systems, Health Science Institute, Federal University of Bahia, Salvador, Bahia, Brazil.,Life Science Department, State University of Bahia, Salvador, Bahia, Brazil
| | - Carlos Maurício Cardeal Mendes
- Postgraduate Studies in Interactive Processes of Organs and Systems, Health Science Institute, Federal University of Bahia, Salvador, Bahia, Brazil
| | | | - Eduardo Pondé De Sena
- Postgraduate Studies in Interactive Processes of Organs and Systems, Health Science Institute, Federal University of Bahia, Salvador, Bahia, Brazil.,Department of Pharmacology and Physiology, Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil
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Postoperative Physiotherapy After Open Temporomandibular Joint Surgery: A 3-Step Program. J Oral Maxillofac Surg 2019; 77:932-950. [DOI: 10.1016/j.joms.2018.12.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 12/24/2018] [Accepted: 12/24/2018] [Indexed: 11/30/2022]
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Comparison of two physiotherapy programmes for rehabilitation after temporomandibular joint arthroscopy. Int J Oral Maxillofac Surg 2018; 47:755-761. [DOI: 10.1016/j.ijom.2017.10.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 09/01/2017] [Accepted: 10/23/2017] [Indexed: 11/17/2022]
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