Effectiveness of physical therapy in addition to occlusal splint in myogenic temporomandibular disorders: protocol of a randomised controlled trial

Abstract

IntroductionTemporomandibular disorders (TMDs) are considered a collection of musculoskeletal conditions involving the masticatory muscles, the temporomandibular joint and associated structures. The myogenous group appears to represent the most frequently diagnosed category. In the context of a multimodal approach, splint therapy and musculoskeletal physiotherapy are often considered as a preferred therapy. The purpose of this study will be to investigate the effects of musculoskeletal physiotherapy combined with occlusal splint and education versus occlusal splint and education alone in the treatment of chronic myogenous TMD on pain and mandibular range of motion.Methods and analysisAll consecutive adults complaining of TMDs presented to the Department of Biomedical and Neuromotor Sciences of the University of Bologna will be considered eligible. Inclusion criteria shall be based on the presence of myogenous TMDs, as diagnosed through clinical examination in reference to the international diagnostic criteria of TMDs. Randomisation, concealed allocation, blinded assessment and intention-to-treat analysis will be employed. The splint therapy will consist of the use of the splint every night and concurrent delivery of an educational programme; the protocol shall have a duration of three consecutive months. The combined musculoskeletal physiotherapy, splint therapy and education will additionally consist of manual therapy techniques and exercise; such protocol shall consist of a duration of three consecutive months, inclusive of 10 sessions for the enhanced elements. All outcome measures will be collected at baseline, after treatment and at a 6 months follow-up.Ethics and disseminationEthical approval has been obtained from the Independent Ethic Committee in Clinical Research of AUSL Bologna-Italy (47/2018/SPER/AUSLBO). Pursuant to applicable rules,we will obtain informed consent from each participant and collect data anonymously to maintain privacy. Results will be disseminated to clinicians and researchers through peer-reviewed publications and conferences.Trial registration numberNCT03726060

Diagnosis and Treatment of Myogenous Temporomandibular Disorders: A Clinical Update

“…Physiotherapy, also termed physical therapy or exercise therapy, has been proposed to play a vital role, especially in the management of myofascial pain complaints for patients with TMD [ 8 , 48 , 68 , 69 , 70 , 71 , 72 ]. It can be subdivided into self-exercise conducted by patients at home or manual therapy by a trained practitioner [ 73 ].…”

Efficiency of occlusal splint therapy on orofacial muscle pain reduction: a systematic review

“…During the analysis of full-text versions, some studies were rejected due to different TMD diagnoses than muscle pain in the study group, inclusion of TMD patients without pain, no proper index to measure the pain level, or no control group [ 34 – 38 ]. One study was not completed during the writing of this systematic review [ 39 ]. Details on the selection of studies are shown in a flowchart (Fig.…”

Physical therapy in addition to occlusal splint in myogenic temporomandibular disorders: A randomised controlled trial

“…The educational program was provided throughout a brochure to all participants by the same clinician (CI). It consisted of a series of advices aimed at increasing awareness about oral behaviours and their detrimental effect on the masticatory muscles 20 …”