The Effect of PIR and MRT on Muscle Stiffness and Pain in Individuals With Bruxism

NCT ID: NCT06450782

Last Updated: 2025-04-17

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-06-15
• Study Completion Date: 2024-10-15

Brief Summary

Bruxism is a repetitive jaw muscle activity that occurs during sleep or while awake, characterized by teeth clenching or grinding. Bruxism affects millions of people worldwide and is considered one of the most harmful activities for the stomatognathic system due to its morphological, pathophysiological, psychosocial features and clinical consequences. Repetitive teeth clenching and grinding movements can cause spasms, stiffness, pain, and activity changes in the chewing muscles. Since bruxism is a disorder that depends on many variables, there is no single, specific treatment and multidisciplinary approaches are often required. Most treatment strategies are conservative and symptomatic, aiming to prevent the consequences of the disorder. The main purpose of physiotherapy techniques is to reduce the negative effects of bruxism on the chewing system. Physiotherapy techniques include exercises, manual therapy, electrotherapy, acupuncture, and posture awareness. It is not clear in the literature which physiotherapy techniques are effective in the management of bruxism; Therefore, more controlled studies need to be conducted. When studies in the literature are examined, no studies have been found that objectively investigate the effectiveness of relaxation techniques alone in people with muscle pain and increased muscle stiffness due to teeth clenching problems. Within the scope of this project, it is planned to investigate the effectiveness of the myofascial release technique (MRT) and post-isometric relaxation technique (PİRT) using the grastone tool.

Detailed Description

Bruxism is a repetitive jaw muscle activity that occurs during sleep or while awake, characterized by teeth clenching or grinding. Bruxism affects millions of people worldwide and is considered one of the most harmful activities for the stomatognathic system due to its morphological, pathophysiological, psychosocial features and clinical consequences. Repetitive teeth clenching and grinding movements can cause spasms, stiffness, pain, and activity changes in the chewing muscles. Since bruxism is a disorder that depends on many variables, there is no single, specific treatment and multidisciplinary approaches are often required. Most treatment strategies are conservative and symptomatic, aiming to prevent the consequences of the disorder. The main purpose of physiotherapy techniques is to reduce the negative effects of bruxism on the chewing system. Physiotherapy techniques include exercises, manual therapy, electrotherapy, acupuncture, and posture awareness. It is not clear in the literature which physiotherapy techniques are effective in the management of bruxism; Therefore, more controlled studies need to be conducted. When studies in the literature are examined, no studies have been found that objectively investigate the effectiveness of relaxation techniques alone in people with muscle pain and increased muscle stiffness due to teeth clenching problems. Within the scope of this project, it is planned to investigate the effectiveness of the myofascial release technique (MGT) and post-isometric relaxation technique (PGT) using the grastone tool. MGT provides pain relief and functional recovery by creating a low load and long-term stretching effect on the myofascial structure. Post-isometric relaxation technique (PGT), a muscle energy technique, involves voluntary contraction in a precisely controlled direction against resistance. The results of this study will reveal the effects of MGT and PGT, which have different mechanisms of action, on muscle stiffness and pain in people with bruxism. In addition, by analyzing and presenting the data obtained, the gap in the current literature will be filled and it will contribute to becoming a component of the frequently used physiotherapy program in the management of bruxism. It is expected that patients' quality of life and productivity will increase depending on the relief of their symptoms. The study is a prospective, randomized, controlled, double-blind study. People with bruxism will be informed about the study and an informed consent form will be obtained. Participants' age, gender, body weight, height and Body Mass Index (BMI) will be evaluated and recorded with a specially prepared evaluation form. Individuals with bruxism between the ages of 18-65 who volunteer to participate in the study will be included. The study included patients with neurological, psychiatric, or systemic disease, dental treatment or physical therapy, using occlusal splints, being pregnant and having active cancer, having surgery planned for the relevant areas, having no more than two molars, using removable prostheses, and those using temporomandibular joint in the last three months. People receiving treatment will be excluded. Participants will be randomly divided into three groups. Participants will be assigned to the MGT group, PGT group, and Control group. In our study, MyotonPRO will be used to evaluate the stiffness of the sternocleidomastoid and masseter muscles of bruxism patients and the visual analog scale will be used to evaluate pain. All evaluations will be made by the same researcher before and immediately after the single-session intervention. No intervention will be made to the chin and cervical area before the first measurement. There will be a 2-minute break before the second evaluation begins.

Conditions

Bruxism; Post-isometric Relaxation Technique; Myofascial Release Technique

Study Design

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

Study Groups

PIR Group

Participants in the PIR Group will apply one session of post-isometric relaxation technique.

Group Type: EXPERIMENTAL

Post-isometric Relaxation Technique

Intervention Type: OTHER

Sternocleidomastoid muscle Participants are asked to stretch their necks in a spuni position and then turn their heads as far to the side of the target muscle (right side) as possible until a sensation occurs that causes discomfort in the targeted SCM. In this case, the participants are asked to moderately isometrically contract the SKM muscle for 5 seconds and then relax for 3 seconds and the cervical spine is moved to the new barrier.

Masseter muscle Participants are positioned in a sitting position. The jaw is opened as wide as possible. The index and middle fingers of one hand are placed over the lower teeth. The weight of the hand is allowed to provide flexion and traction is applied directly to the midline. In this case, the participants are asked to moderately isometrically contract the bilateral masseter muscles for 5 seconds, then relax for 3 seconds and the participant moves his chin to the new barrier.

Control

Intervention Type: OTHER

Participants will rest for thirty minutes.

MR Grup

Participants in the MR Group will apply one session of myofascial release technique.

Group Type: EXPERIMENTAL

Myofascial Release Technique

Intervention Type: OTHER

Sternocleidomastoid muscle The head is slightly elevated with the help of a folded towel to prevent discomfort that may develop depending on the position. The researcher sits in a chair next to the participant's head. The chair is placed at approximately 45° to the participant's neck. The participant's head is rotated 30° towards the opposite side of the treated side. The Graston instrument contacts the upper part of the SCM approximately 2 cm below the mastoid process.

Masseter muscle It works both ways. The Graston instrument is placed on the zygomatic process of the temporal bone, approximately 1 cm in front of the ear. The soft tissue is pressed until the bone is contacted. This connection with the periosteum is maintained and a lower tension line is created towards the mandible angle. This line of tension is continued up to the mandible, where the periosteum also comes into play. It is repeated several times.

Control Group

No intervention will be made to the participants in the Control Group.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Post-isometric Relaxation Technique

Sternocleidomastoid muscle Participants are asked to stretch their necks in a spuni position and then turn their heads as far to the side of the target muscle (right side) as possible until a sensation occurs that causes discomfort in the targeted SCM. In this case, the participants are asked to moderately isometrically contract the SKM muscle for 5 seconds and then relax for 3 seconds and the cervical spine is moved to the new barrier.

Masseter muscle Participants are positioned in a sitting position. The jaw is opened as wide as possible. The index and middle fingers of one hand are placed over the lower teeth. The weight of the hand is allowed to provide flexion and traction is applied directly to the midline. In this case, the participants are asked to moderately isometrically contract the bilateral masseter muscles for 5 seconds, then relax for 3 seconds and the participant moves his chin to the new barrier.

Intervention Type: OTHER

Myofascial Release Technique

Sternocleidomastoid muscle The head is slightly elevated with the help of a folded towel to prevent discomfort that may develop depending on the position. The researcher sits in a chair next to the participant's head. The chair is placed at approximately 45° to the participant's neck. The participant's head is rotated 30° towards the opposite side of the treated side. The Graston instrument contacts the upper part of the SCM approximately 2 cm below the mastoid process.

Masseter muscle It works both ways. The Graston instrument is placed on the zygomatic process of the temporal bone, approximately 1 cm in front of the ear. The soft tissue is pressed until the bone is contacted. This connection with the periosteum is maintained and a lower tension line is created towards the mandible angle. This line of tension is continued up to the mandible, where the periosteum also comes into play. It is repeated several times.

Intervention Type: OTHER

Control

Participants will rest for thirty minutes.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

Being diagnosed with bruxism Being willing and volunteer to work

Exclusion Criteria

Having a neurological, psychiatric or systemic disease Being addicted to alcohol and drugs Getting dental treatment or physical therapy Using an occlusal splint being pregnant actively having cancer Planning surgery for relevant areas Not having more than two molars Using removable dentures Receiving treatment for the temporomandibular joint in the last three months

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Istinye University

OTHER

Sponsor Role: lead

Responsible Party

Yunus Emre Tutuneken

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Yunus Emre TÜTÜNEKEN

Istanbul, Zeytinburnu, Turkey (Türkiye)

Countries

Turkey (Türkiye)

Other Identifiers

13

Identifier Type: -

Identifier Source: org_study_id