Effect of Manual Therapy on Jaw Movement and Function in Patients With Bruxism

NCT ID: NCT03753529

Last Updated: 2018-11-27

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 120 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2019-01-31
• Study Completion Date: 2020-05-31

Brief Summary

Hypothesis

1. There will be no significant statistical effect of Trigger Point Pressure release and Deep striking massage on pain level in patients with bruxism.

2. There will be no significant statistical effect of Trigger Point Pressure release and Deep striking massage on Range of Motion in patients with bruxism.

3. There will be no significant statistical effect of Trigger Point Pressure release and Deep striking massage on Sleep Quality Index in patients with bruxism.

4. There will be no significant statistical effect of Trigger Point Pressure release and Deep striking massage on proprioception awareness in patients with bruxism.

5. There will be no significant statistical effect of Trigger Point Pressure release and Deep striking massage on Stress in patients with bruxism.

6. There will be no significant statistical effect of Trigger Point Pressure release and Deep striking massage on Anxiety in patients with bruxism.

7. There will be no significant statistical effect of Trigger Point Pressure release and Deep striking massage on Temporomandibular (TMJ) function in patients with bruxism.

8. There will be no significant statistical effect of Trigger Point Pressure release and Deep striking massage on Oral Health Impact Profile in patients with bruxism.

Conditions

Bruxism; TMJ Pain

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

deep friction massage group

Group Type: EXPERIMENTAL

Deep friction massage

Intervention Type: OTHER

Submitted to three session weekly 30-minute sessions of therapy will performed by the administration of sliding and kneading maneuvers of the masseter and temporalis muscles, bilaterally,lateral pterygoid and digastric over four consecutive weeks (total:12 sessions) Sliding consisted of a unidirectional movement in which part of the therapist's hand (mainly the fingertips) will used, moving from the proximal to the distal portion of the face with constant, progressive pressure compatible with the status of each tissue. The degree of pressure varied depending on the level of pain, sensitivity and tension in each individual. Kneading consisted of a gripping maneuver of a muscle group or portion of a muscle.Then follow-up with a passive stretch to the muscle. This will repeated for three to five times for three sessions per week for 4 weeks.

pressure release group

Group Type: EXPERIMENTAL

Pressure release

Intervention Type: OTHER

First, using a pincer grasp moved throughout the fibers of the pterygoid, masseter, digastric and temporalis muscles to palpate the muscle aiming to locate a trigger point . A common location is detected according to Simon and Travell book. Once located on the trigger point, apply an IC by gradually applying pressure to the trigger point with your thumb. Keep in communication with the patient, checking to ensure that in staying within the limits of his pain tolerance. Hold this technique for approximately 20 seconds to 1 minute, patient tells you that pain has diminished, or until feels the muscle fibers begin to relax under your pressure. Once feel this release, gradually release pressure. All identified trigger points were treated. Then follow-up with a passive stretch to the muscle. This will repeated for three to five times for three sessions per week for 4 weeks.

control group

Group Type: EXPERIMENTAL

control group

Intervention Type: OTHER

Stretching and transcutaneous electrical nerve stimulation

Interventions

Deep friction massage

Submitted to three session weekly 30-minute sessions of therapy will performed by the administration of sliding and kneading maneuvers of the masseter and temporalis muscles, bilaterally,lateral pterygoid and digastric over four consecutive weeks (total:12 sessions) Sliding consisted of a unidirectional movement in which part of the therapist's hand (mainly the fingertips) will used, moving from the proximal to the distal portion of the face with constant, progressive pressure compatible with the status of each tissue. The degree of pressure varied depending on the level of pain, sensitivity and tension in each individual. Kneading consisted of a gripping maneuver of a muscle group or portion of a muscle.Then follow-up with a passive stretch to the muscle. This will repeated for three to five times for three sessions per week for 4 weeks.

Intervention Type: OTHER

Pressure release

First, using a pincer grasp moved throughout the fibers of the pterygoid, masseter, digastric and temporalis muscles to palpate the muscle aiming to locate a trigger point . A common location is detected according to Simon and Travell book. Once located on the trigger point, apply an IC by gradually applying pressure to the trigger point with your thumb. Keep in communication with the patient, checking to ensure that in staying within the limits of his pain tolerance. Hold this technique for approximately 20 seconds to 1 minute, patient tells you that pain has diminished, or until feels the muscle fibers begin to relax under your pressure. Once feel this release, gradually release pressure. All identified trigger points were treated. Then follow-up with a passive stretch to the muscle. This will repeated for three to five times for three sessions per week for 4 weeks.

Intervention Type: OTHER

control group

Stretching and transcutaneous electrical nerve stimulation

Intervention Type: OTHER

Other Intervention Names

Ischemic pressure and ischemic compression (IC); Stretching and transcutaneous electrical nerve stimulation

Eligibility Criteria

Inclusion Criteria

1. The volunteers diagnosed with bruxism based on the criteria of the American Academy of Sleep Medicine

2. Positive self-report of awake bruxism.

3. Self-report of muscle fatigue or tenderness on awakening.

4. Sleeping partner reports of grinding sounds during the night in the last 6 months, or awake clenching.

Exclusion Criteria

1. Severe psychological disorder and/or the use of antipsychotic psychotropic drugs(with the exception of anxiety and depression).

2. Using medications that influence sleep or motor behavior.

3. Direct trauma or past surgery in the orofacial region.

4. On physical, speech, dental, or psychological therapy at the time of study entry.

5. Currently undergoing physical therapy for TMD.

6. Neurological or central nervous system and/or peripheral nervous system disorders or history of neuromuscular disease.

7. The presence of prosthesis or extensive prosthetic restorations and the presence of gross malocclusion.

8. More than two missing teeth, except third molars;

9. Systemic and/or degenerative diseases.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 40 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Cairo University

OTHER

Sponsor Role: lead

Responsible Party

HAhmed

lecture of biomechanics

Responsibility Role: PRINCIPAL_INVESTIGATOR

Other Identifiers

P.T.REC/012/001936

Identifier Type: -

Identifier Source: org_study_id