Long-term efficacy and patient satisfaction of pulsed radiofrequency therapy in temporomandibular disorders

Abstract

Background: Pulse radiofrequency (PRF) therapy is one of effective physical therapy modalities for treat temporomandibular disorders (TMD). This prospective randomized controlled trial aimed to evaluate the long-term treatment efficacy and patient satisfaction with PRF therapy in TMD. Methods: Eighty-six female patients with TMD were randomly assigned to either pulsed radiofrequency or placebo therapy in combination with other conventional treatments once a week for 12 weeks. A final analysis was performed 12 weeks after the completion of treatment. Clinical parameters and patient satisfaction were analyzed at baseline, 4, 8, and 12 weeks of intervention and at 24 weeks from baseline. Results: Pain intensity, comfortable and maximum mouth opening, and pain on capsule and masticatory muscle palpation were significantly improved after treatment in both groups. Notably, the pulsed radiofrequency group showed a significantly lower pain intensity at the final evaluation performed 3 months after the completion of treatment. Significantly more patients reported subjective pain improvement and satisfaction with treatment following intervention at baseline in the PRF group. Most patients did not report any discomfort following treatment in either group. However, significantly more patients in the PRF group reported a burning sensation with intervention. Conclusion: Long-term regular pulsed radiofrequency therapy was effective in significantly reducing TMD pain, and the effect was long-lasting following treatment completion. Pulsed radiofrequency therapy should be considered as a supportive physical therapy modality for TMD.

Effectiveness of electrotherapy for the treatment of orofacial pain: A systematic review and meta-analysis

“…A systematic review 7 found one study that used pulsed radiofrequency energy therapy for arthrogenous temporomandibular disorders and concluded that there was limited evidence to support the use of pulsed radiofrequency energy. Only two studies 35,70 were found by the present systematic review for pulsed radiofrequency in patients with arthrogenous and mixed temporomandibular disorders. This reinforces the need for more evidence for this therapy and diagnosis.…”

“…After the first screening and full-text screening, 37 studies met all the study criteria and were included in this review. 35–71 Reasons for exclusion are available upon request and outlined in the PRISMA flowchart (Figure 1). After tracking included studies using Scopus and manual search, six additional studies 72–77 were included.…”

“…The other 23 studies 35,36,39,[41][42][43][44]47,50,53,56,[60][61][62]64,[66][67][68]70,72,74,76,77 were not included due to incomplete or inconsistent data, not provided data, even after requesting to authors, 36,38,40,41,49,50,56,68,74 or did not have similar outcomes, comparisons, or conditions that could be pooled. 35,39,[42][43][44]46,47,53,[60][61][62]64,66,67,70,72,76,77 Data were pooled based on the following: a) outcome, b) diagnosis,...…”

“…Al-Badawi et al 35 and Jo et al 70 were the only two studies that investigated pulsed radiofrequency energy as therapy in patients with arthrogenous and mixed temporomandibular disorders, respectively. Al-Badawi et al 35 evaluated pain intensity and range of motion.…”

“…The effect size for the pulsed radiofrequency energy was better than the placebo on pain intensity (standardize mean difference 0.78 mm [95% CI: 0.13, 1.43]) (Supplementary material 3); however, the results for the range of motion were not described. Jo et al 70 evaluated pain intensity, range of motion, and presence of tenderness and joint noise. The found that the pulsed radiofrequency energy plus usual physical therapy (counseling, behavior therapy, splint, thermal heat, ultrasound, laser, transcutaneous electrical nerve stimulation, and medication) group was better than usual physical therapy to improve the presence of joint noise; however, no difference was found between groups for pain intensity (standardize mean difference −0.08 [95% CI: −0.50, 0.35]), range of motion (standardize mean difference 0.01 mm [95% CI: −0.41, 0.43]), and presence of tenderness (Supplementary material 3).…”