Effectiveness of Physical Therapy in the Correction of the Functional Status of the Temporomandibular Joint in Arthrosis

Abstract

The purpose of the study was to evaluate the effect of a physical therapy program on the state of functioning of the maxillofacial region in patients with arthrosis of the temporomandibular joint. Materials and methods. The study involved 33 people with arthrosis of the temporomandibular joint of the II-III degrees, which were divided into 2 groups – control and main. The control group consisted of 18 people who received arthrosis therapy only with non-steroidal anti-inflammatory drugs. The main group consisted of 15 people who additionally underwent the developed program of physical therapy (therapeutic exercises, massage, post-isometric relaxation, kinesiotaping of the masticatory muscles, neck muscles, cervical-collar zone; paraffin therapy course for the temporomandibular joint area, patient education). Complaints of patients, the intensity of pain in the temporomandibular joint on a visual analogue scale, the amount of mouth opening were determined, and auscultation of the joint was performed. Results and discussion. After the completion of the treatment course (for patients of the control group) and physical therapy (for the patients of the main group), pain in the temporomandibular joint did not manifest itself at rest and during movement. This is explained, in particular, by the fact that the basis of conservative treatment of arthrosis is the use of non-steroidal anti-inflammatory drugs with analgesic effects. At the same time, the usage of physical therapy, in comparison with medications, in the main group was statistically significant (p <0.05) in relation to control patients, it improved the functional activity of the jaw area and the functioning of the temporomandibular joint, which was manifested by a decrease in the number of persons with complaints of pathological sounds during jaw movements and their auscultatory detection, discomfort when chewing, as well as an increase in the magnitude of opening the mouth. Restoration of the condition of patients with diseases of the maxillofacial region, and, in particular, the temporomandibular joint, is an urgent problem not only for dentists, but also for specialists in the field of rehabilitation, in particular, physical therapists. The objectives of physical therapy in patients with arthrosis of the temporomandibular joint are to reduce the load on the joint, eliminate and reduce pain, synovitis, myalgia, improve joint function, stimulate and activate metabolic processes in cartilaginous and bone tissues, normalize blood flow, and thus improve quality of life. Conclusion. Physical therapy means improve the functional ability of the temporomandibular joint in the complex recovery of patients with arthrosis statistically significantly better than monotherapy with non-steroidal anti-inflammatory drugs

Physical therapy for injuries of the temporomandibular joint

“…The patient was also taught about the correction of daily motor and functional load on the joint, including the limitation of wide opening of the mouth, prolonged chewing and other recommendations, such as the elimination of bad habits (clicking seeds, nuts, holding objects with the teeth, etc.) (Aravitska, 2021)�…”

Dynamics of Post-Mobilization Functional Limitations of the Orofacial Zone in Patients After Fracture of the Mandibula Under the Influence of Rehabilitation Measures

“…Реабілітаційні засоби, зокрема, засоби фізичної терапії, ерготерапії, мають доведену ефективність для корекції структурних та функціональних змін внаслідок іммобілізації, тому широко застосовуються у травматології. Вони мають протизапальну, знеболюючу, спазмолітичну, міостимулюючу дію, покращують локальну гемодинаміку, обмінні процеси, зменшують запалення синовіальної оболонки [8,9,10]. Це спричиняє зменшення інтенсивності клінічних ознак захворювання, що було підтверджено у нашому дослідженні.…”

“…Важливою умовою для успішнішого лікування переломів нижньої щелепи є можливість більш раннього відновлення активності м'язів у післяопераційному або постіммобілізаційному періоді, що сприятливо впливає на утворення кісткового мозоля. При повному загоєнні перелому нижньої щелепи застосування засобів реабілітаційного спрямування дозволяє швидко відновити всі функції зубощелепної системи [8,9,10].…”