Standard Care With LLLT & Myofascial Release Versus Standard Care Alone in Pregnant Women With Temporomandibular Disorder

NCT ID: NCT05138354

Last Updated: 2021-12-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-02-18

Study Completion Date

2021-10-26

Brief Summary

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This study will investigate a novel approach to treat pregnant women with tempromandibular disorder using a combined method of low level laser therapy, myofascial release and standard care versus standard care alone. It's hopeful that the results of this study can fill the gap of knowledge surrounding the conservative treatment options for TMD in order to help patients restore their oral function properly and promote new ways of addressing TMD.

Detailed Description

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Conditions

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Temporomandibular Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Caregivers Outcome Assessors

Study Groups

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Control group

Patients received a 4-week treatment program (12 treatment sessions, three times a week). Patients received the conservative treatment protocol comprised of ultrasound, hot pack application, and exercises.

Group Type ACTIVE_COMPARATOR

Standard care

Intervention Type OTHER

1. Ultrasound Participants will receive an application of pulsed ultrasound at a frequency of 3 MHz and an intensity of 0.5 W/cm² with a 1:1 duty cycle over TMJ for six minutes.
2. Hot pack Participants will receive a warm water pack the TMJ and masticatory muscles for 10 minutes.
3. Exercise program:

Active exercises for mandibular muscles will be used to correct the mouth opening

1. Lateral movements of the jaw (3 sets of 10 repetitions).
2. Jaw relaxation exercise (3 sets of 10 repetitions).
3. Chin tuck (10 repetitions, holding 10s each).
4. Resisted opening of the mouth (3 sets of 10 repetitions).
5. Resisted closing of the mouth (3 sets of 10 repetitions).
6. Stretching exercise for mandibular muscles.

Intervention group

Patients received a 4-week treatment program (12 treatment sessions, three times a week). Patients received LLLT and myofascial release combined with the control intervention. the conservative treatment protocol comprised of ultrasound, hot pack application, and exercises

Group Type EXPERIMENTAL

Low Level laser therapy

Intervention Type OTHER

MLS® device (ASA Srl, Vicenza, Italy) IR laser with two synchronized sources (laser diodes) and a wavelength of 808 nm to deliver the intervention. The laser probe will be held vertically in contact with the skin to deliver the irradiation at three mandibular condyle points (front, behind and over) and one point at the external acoustic meatus. The irradiation will be applied with a laser bean of 3.14 cm² diameter for 14 seconds at each place using a pulse rate of 1500 Hz, pulse duration of 100ns, and energy density: 16 J/cm².

Myofascial release

Intervention Type OTHER

Patients will be positioned in supine in a treatment table. The therapist seated beside the patient at the side of affected temporomandibular joint to apply gross release technique for masseter, pterygoid and temporalis muscles. At each point, the therapist applied the technique for 90 seconds and repeated 5 times during the session (5 seconds of rest between each repetition).(15) The therapist worn gloves to deliver the intraoral myofascial release. In case the patient reported any latex allergies, the gloves were replaced by a latex free model.

Standard care

Intervention Type OTHER

1. Ultrasound Participants will receive an application of pulsed ultrasound at a frequency of 3 MHz and an intensity of 0.5 W/cm² with a 1:1 duty cycle over TMJ for six minutes.
2. Hot pack Participants will receive a warm water pack the TMJ and masticatory muscles for 10 minutes.
3. Exercise program:

Active exercises for mandibular muscles will be used to correct the mouth opening

1. Lateral movements of the jaw (3 sets of 10 repetitions).
2. Jaw relaxation exercise (3 sets of 10 repetitions).
3. Chin tuck (10 repetitions, holding 10s each).
4. Resisted opening of the mouth (3 sets of 10 repetitions).
5. Resisted closing of the mouth (3 sets of 10 repetitions).
6. Stretching exercise for mandibular muscles.

Interventions

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Low Level laser therapy

MLS® device (ASA Srl, Vicenza, Italy) IR laser with two synchronized sources (laser diodes) and a wavelength of 808 nm to deliver the intervention. The laser probe will be held vertically in contact with the skin to deliver the irradiation at three mandibular condyle points (front, behind and over) and one point at the external acoustic meatus. The irradiation will be applied with a laser bean of 3.14 cm² diameter for 14 seconds at each place using a pulse rate of 1500 Hz, pulse duration of 100ns, and energy density: 16 J/cm².

Intervention Type OTHER

Myofascial release

Patients will be positioned in supine in a treatment table. The therapist seated beside the patient at the side of affected temporomandibular joint to apply gross release technique for masseter, pterygoid and temporalis muscles. At each point, the therapist applied the technique for 90 seconds and repeated 5 times during the session (5 seconds of rest between each repetition).(15) The therapist worn gloves to deliver the intraoral myofascial release. In case the patient reported any latex allergies, the gloves were replaced by a latex free model.

Intervention Type OTHER

Standard care

1. Ultrasound Participants will receive an application of pulsed ultrasound at a frequency of 3 MHz and an intensity of 0.5 W/cm² with a 1:1 duty cycle over TMJ for six minutes.
2. Hot pack Participants will receive a warm water pack the TMJ and masticatory muscles for 10 minutes.
3. Exercise program:

Active exercises for mandibular muscles will be used to correct the mouth opening

1. Lateral movements of the jaw (3 sets of 10 repetitions).
2. Jaw relaxation exercise (3 sets of 10 repetitions).
3. Chin tuck (10 repetitions, holding 10s each).
4. Resisted opening of the mouth (3 sets of 10 repetitions).
5. Resisted closing of the mouth (3 sets of 10 repetitions).
6. Stretching exercise for mandibular muscles.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Pregnant women diagnosed with myofascial TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders

Exclusion Criteria

* facial neuro-musculoskeletal pathologies (i.e., facial trauma and/or fractures, and bell's palsy)
* acute infections or systemic disorders
* osteoporosis
* cervical spine or upper limb dysfunction
* steroid infiltration4
* any recent dental treatment taken or surgery over TMJ
* hypermobile joint
* neurological impairments
Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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October 6 University

OTHER

Sponsor Role lead

Responsible Party

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Mohamed Magdy Ali Hassan ElMeligie

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Radwa M Yehia, Ph.D

Role: STUDY_DIRECTOR

Faculty of Physical Therapy, October 6 University

Locations

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October 6 University Hospital

Al Ḩayy Ath Thāmin, Giza Governorate, Egypt

Site Status

Countries

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Egypt

Other Identifiers

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PTMD2021

Identifier Type: -

Identifier Source: org_study_id