Physical Therapy of Temporomandibular Joint Disorders. Part II.

OBJECTIVES The aim is to assess the knowledge, attitude and practice of dental practitioners concerning physiotherapy management of Temporomandibular joint dysfunctions (TMDs.). METHOD 61 dentists were included from Tertiary, secondary and private dental clinics of Karachi, and the study design was cross sectional. RESULTS Prior to survey 45.9% of did not had knowledge about physical therapy management TMD. Maxillofacial surgeons and master’s degree holders had more knowledge about physical therapy (PT) management. 45.9% dentists reported that PT is non-effective treatment approach. Lack of knowledge on dentist’s behalf is the foremost cause of less referral to PT 88.5%. Jaw exercises were prescribed by 83.6% of dentists. In the end of the survey 52.5% dentists were reluctant to refer, 47.5% were maybe they will refer and 96.7% dentists were eager to gain more knowledge about the benefits of PT and collaborative treatment. CONCLUSIONS This study concluded that the dental practitioners of Karachi lack knowledge, attitude and practice regarding physiotherapy treatment of TMD. The benefits of multidisciplinary approach while treating TMDs were not very well known to dental practitioners and its benefits to patients. This study increased the knowledge of surveyed practitioners KEYWORDS Dentistry, Masticatory Muscles, Temporomandibular Joint Disorders, Orthodontics, Temporomandibular Joint, Manipulation

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Effect of Diclofenac Gel Phonophoresis on Temporomandibular Joint Disorders: A Prospective Quasi-Experimental Study

Middle East Journal of Rehabilitation and Health ◽

10.5812/mejrh.102928 ◽

2020 ◽

Vol 7 (3) ◽

Author(s):

Marcos Edgar Fernandez-Cuadros ◽

Luz Otilia Casique Bocanegra ◽

Maria Jesus Albaladejo-Florin ◽

Sandra Alava-Rabasa ◽

Olga Susana Perez-Moro

Keyword(s):

Physical Therapy ◽

Temporomandibular Joint ◽

Outcome Measures ◽

Mouth Opening ◽

Masticatory Muscles ◽

Temporomandibular Joint Disorders ◽

Function Recovery ◽

Quasi Experimental ◽

Interincisal Distance ◽

And Function

Background: Temporomandibular disorders (TMD) are a group of pathologies that affect the masticatory muscles, the temporomandibular joint, and related structures and affect more than 25% of the general population. Objectives: This study aimed to demonstrate the effect of ultrasounds (US) plus diclofenac gel 10% (phonophoresis) as a physical therapy available for the management of TMD based on pain amelioration and function recovery. Methods: Prospective quasi-experimental one-group before-after study. Outcome measures consist: (1) pain measured by Visual Analog scale (VAS); and (2) mouth opening by measuring lip to lip distance and interincisal distance in millimeters (mm); evaluated at the beginning/end of treatment. Twenty sessions (1 session per day) of continuous Ultrasound to intensity of 1 W/cm2/1 MHz/5 minutes over the affected joint, with Ultrasound gel (5 mL) and 10% diclofenac gel (5 mL) in a proportion of 1:1 as transducer medium. Results: A total of 50 consecutive patients were analyzed. Phonophoresis protocol was able to improve all outcome measures with a statistical difference. Pain evaluated by VAS was 6.67 ± 0.82 and decreased to 3.48 ± 0.8 points (P = 0.0000). Mouth opening by mean of lip-to-lip distance was 50 ± 8.23 mm that improved to 56 ± 6.2 mm (P = 0.0000) and by mean of interincisal distance was 37.9 ± 7.02 mm and increased to 44 ± 5.5 mm (P = 0.0000). Conclusions: Diclofenac phonophoresis is an effective physical therapy for the management of TMD, evaluated by pain improvement and function recovery.

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