Physiotherapeutic Rehabilitation in Patients After Orthognathic Surgery
Condition: TMJ Pain
Study type: Interventional

Summary: 
      Orthognathic surgery procedures are often used to correct for skeletal II and III skeletal
      deformation, dental-facial-maxillary deformation, mandibular laterognathy and maxillofacial
      asymmetry. The factors that motivate patients to undergo this procedure are: improvement of
      chewing, speech and swallowing as well as aesthetic and psychosocial factors. Correction of
      occlusal-facial defects requires team orthodontic, surgical and rehabilitation treatment. As
      with any surgical procedure, various preoperative, intraoperative and postoperative
      com-plications may occur. Late complications that may occur in variously long periods of time
      from surgery include among others dysfunction of the temporomandibular joint, idiopathic
      atrophy of the condyloid muscles and associated pain. After orthognathic operations, pain
      occurs almost always, although the degree of its severity is a subjective sensation of each
      patient. Regardless of intensity, the fight against pain is one of the basic activities in
      post-operative care of the patient. The aim of the study was to evaluate the effectiveness of
      the physiotherapeutic method, which uses a slow-changing electromagnetic field and light
      ener-gy emitted from high-energy LEDs - light emitting diode, Magnetholedoterpy, in reducing
      pain in patients after orthognathic surgery Using the Viofor JPS device (Med & Live)
    

Detailed description: 
      BACKGROUND:

      Patients with dental-facial deformity require orthognathic surgery to improve face profile
      and asymmetry, and to correct malocclusion. Positional changes in the mandible, jaw or both
      jaws during can affect the temporomandibular joint (TMJ), chewing muscles, surrounding soft
      tis-sue and symptoms of joint dysfunction (TMD). Pain is a natural response of the body to
      injury and at the same time one of the symptoms defining the inflammatory reaction.
      Orthognathic surgery procedures are often used to correct skeletal deformation II and III of
      the skeletal class, dental-facial-maxillary deformation, mandibular laterognathion and
      maximal-facial asymmetry. After-care care of the patient aims to minimize the risk of
      complications and therapy of existing ones. Regardless of intensity, the fight against pain
      is one of the basic activities in post-operative care of the patient. Some studies have shown
      that patients undergo-ing physiotherapeutic care immediately recover from the surgery much
      more quickly. The use of physical treatments allows to obtain a significant faster
      improvement in the pain and associated swelling after surgery.

      PROBLEM:

      The motivating factors for patients undergoing orthognathic surgery are: improvement of
      chewing, speech and swallowing as well as aesthetic and psychosocial factors. Correction of
      occlusal defects requires a group orthodontic, surgical and rehabilitation treatment.
      Surgical techniques that have evolved over the last decades now allow for almost any
      displacement within the bony structures of the jaw and mandible. The pain after orthogonal
      surgery occurs almost always, although the degree of its severity is the subjective sensation
      of each patient. Patients above all experience pain from mild to severe. His post-operative
      treatment is very important to reduce the stress caused the occurrence itself pain.
      Postoperative pain is often controlled by the use of opioids, which are often used in the
      United States. Cold compresses are also used in the stimulus treatment to reduce pain related
      associated with the occurrence of edema. Regardless of intensity, the fight against pain is
      one of the basic activities in post-operative care of the patient. Pharmacotherapy often
      necessary also causes a number of adverse effects harmful to the whole organism. In order to
      restore the physical and psychological comfort of patients after orthognathic procedures,
      physiotherapeutic methods as well as physiotherapeutic devices can be used.

      AIM:

      The aim of the study was to assess the effectiveness of the combined physiotherapeutic
      method, which uses a slow-changing electromagnetic(ELF EMF) field and light energy, emitted
      from high-energy LEDs, in reducing pain in patients after orthognathic surgery.
    

Intervention name(s): VIOFOR (Med & Life)
Intervention type(s): Device
Intervention description(s): Device: VIOFOR (Med & Life) Magnetic-light applicators, generating a slow-changing electromagnetic field and light ener-gy (830 nm and 640 nm), emitted from LEDs during a physiotherapeutic treatment application parameters: frequency of basic field pulses: 180-195 Hz frequency of packet the field pulses: 12.5 Hz-29 Hz magnetic induction: 15 μT wavelength of light: 830 nm and 640 nm Duration: 10 min number of treatments: 10
Other intervention name(s): Combination physicotherapies; Magnetoledotherapy
Intervention model: Single Group Assignment
Intervention model description: Rehabilitation of patients after orthognathic procedures was performed, in which orthognathic surgery was performed - Bilateral Sagittal Split Osteotomy (BSSO). In the study it was used treatments a combination physicotherapies that combines two therapeutic physical factors - the electromagnetic field and the electromagnetic wave of red and infrared light in the form of led light therapy generated by the Viofor JPS device (Med&Life, Poland). Treatments with a slow-changing electromagnetic field were carried out using ring and elliptic applicators. Treatments with magnetoledotherapy using elliptical magnetic applicators combined with light. For physiotherapeutic purposes, led lighttherapy was used, which is a combined use of Extremely Low Frequency Magnetic Field (ELF-MF) and light coming from high energy LEDs (Light Emitting Diode) in the range of red (R) and infrared (IR). Therapies were used once a day, doing three described applications for a period of 10 days.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: pain; orthognathic surgery; temporomandibular disorders (TMD); Electromagnetic Therapy; Light therapy