The Application of Manual Techniques in Masticatory Muscles Relaxation as Adjunctive Therapy in the Treatment of Temporomandibular Joint Disorders

Abstract

Temporomandibular disorders (TMD) are primarily characterized by pain as well as disorders concerning the proper functioning of individual elements of the stomatognathic system (SS). The aim of the study was to compare the degree of relaxation of the anterior part of the temporal muscles and the masseter muscles, achieved through the use of post-isometric relaxation and myofascial release methods in patients requiring prosthetic treatment due to temporomandibular joint disorders with a dominant muscular component. Sixty patients who met the inclusion criteria were alternately assigned to one of the two study groups, either group I—patients received post-isometric relaxation treatment (PIR), or group II—patients received myofascial release treatment (MR). The series of ten treatments were performed in both groups. The comparative assessment was based on physiotherapeutic examination, a surface electromyography (sEMG) of the anterior temporal and masseter muscles and the intensity of spontaneous masticatory muscle pain, assessed using the Visual Analogue Scale (VAS). We observed a significant decrease in the electrical activity of examined muscles and a significant drop in the intensity of spontaneous pain in the masticatory muscles both in group I and II. There were no significant differences between groups. Both therapeutic methods may be used as successful forms of adjunctive therapy in the prosthetic treatment of TMD. The trial was registered with an international clinical trials register.

Diagnosis and Treatment of Myogenous Temporomandibular Disorders: A Clinical Update

“…Furthermore, some widely cited examples of manual therapies are post-isometric muscle relaxation and myofascial release. Although the aforementioned procedures have been more extensively documented in treating muscles of the trunk and limbs, these relaxation techniques have been reported to improve musculoskeletal functions even in the masticatory system, possibly by relief of muscle tension [ 76 ]. A diversity of approaches are available and have been shown to be beneficial in the treatment of TMD, including but not limited to mobilization, stretch, endurance exercise, etc., but as of today, none has been proven superior; more scientific evidence is called for to formulate a standardized protocol [ 73 , 77 , 78 , 79 ].…”

Evaluation of the efficacy of manual soft tissue therapy and therapeutic exercises in patients with pain and limited mobility TMJ: a randomized control trial (RCT).

“…The differences between the study results may be due to the use of a different methodology for conducting the soft tissue therapy procedure in the above study [51]. According to a study by Rodrigez Blanco et al, the PIR technique of the masseter muscle proved to be a more effective method than the tension/counter-tension technique in patients with MPPS and limited mandibular visitation [52].…”

Effects of an Interdisciplinary Approach in the Management of Temporomandibular Disorders: A Scoping Review

“…Although the techniques manual therapy may use are not determinant, therapeutic success can be attributed to the correct diagnosis and adequate combination of multidisciplinary treatment [6]. A recent RCT by Urba ński et al [25] evaluated the efficacy of two different physiotherapy techniques in 70 patients affected by TMD with a dominant muscle component who were divided into two groups: patients in group I underwent postisometric relaxation treatment, and patients in group II were treated with myofascial release treatment. After ten treatments, no significant differences were observed between the groups in terms of pain intensity, and in both groups, there was a significant decrease in the electrical activity of the masticatory muscles examined.…”