Analysis of the Effects of the Osteopathic Manipulative Treatment in Carriers of Temporomandibular Disorders
Condition: Temporomandibular Disorder
MeSH terms: Temporomandibular Joint Disorders; Temporomandibular Joint Dysfunction Syndrome
Study type: Interventional

Summary: 
      The purpose of this study is to determine whether osteopathic manipulative treatment
      associated to Dentistry care and speech therapy improves pain and function in individuals
      with temporomandibular disorders.
    

Detailed description: 
      A standardized TMD examination was executed in all patients by a dentist following the
      Research Diagnostic Criteria for Temporomandibular Disorders (RDC/ TMD) questionnaire, Axis I
      and II, portuguese version. The RDC/ TMD is compound by a 31 items questionnaire and a ten
      items clinical exam. All these items are related to patients symptoms and signs; to
      mandibular functional impairment; and social-demographics, social-economics, psychological e
      psychosocial data. The first part as Axis I tend to clinical assess and classify the TMD and
      the second, as Axis II propose a chronic pain score that could quantify the psychosocial
      impairment and present a subjects profile.

      Others assessment instruments utilized on the research were the VAS consists in a 10 cm
      horizontal line with "no pain" on the left side and "worst pain" on right side, then the
      subjects were instructed to vertical risk the level of pain. The digital caliper with a 0,03
      mm precision was used to measure the maximal mouth opening (MMO) as the maximal inter-incisal
      vertical distance of the incisors. The subjects were seated at 90° with neutral head position
      and solicited to open their mouths the maximum they can unassisted and without pain, maximum
      unassisted opening and maximum assisted opening. Also, a portable digital pressure algometer
      for measuring sensitivity to pressure before it became painful. The masseters and temporalis
      muscles trigger point location were used as reference to guarantee the reproducibility of the
      proceeding as well as to assess the always the same site. The statistical analysis was
      performed using the means comparisons for the parametric tests through Student T test and for
      the non-parametrical data, Wilcoxon. Also, it was made the descriptive statistical with
      frequencies analysis.
    

Intervention name(s): Conventional Group; Osteopathic Group; Ibuprofen; Cyclobenzaprine Hydrochloride
Intervention type(s): Other; Other; Drug; Drug
Intervention description(s): Rigid occlusal splints and medication (Ibuprofen and Cyclobenzaprine Hydrochloride) were made and prescribed under the dentist professor supervision. Likewise, speech therapists performed assessments, measurements, massages, stretches and therapeutic exercises for head, neck and mouth regions.; Same assistance of Conventional Group, cited above, plus the osteopathic care during 20 to 30 minutes once a week during four weeks. The osteopathic treatment consisted in an individualized assessment of mobility restrictions of myofascial tissues and joints and the application of smooth techniques such myofascial release, membranous strain and counterstrain, muscle energy, cranial and high velocity and low amplitude.; The medication was prescribed by the dentist as nonsteroidal anti-inflammatory drug if necessary.; The medication was prescribed by the dentist as muscle relaxer if necessary.
Other intervention name(s): anti-inflammatory drug; muscle relaxer
Intervention MeSH terms: Ibuprofen; Anti-Inflammatory Agents; Cyclobenzaprine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Temporomandibular Disorder; Osteopathic Manipulative Treatment; Rigid Splint; Speech Therapy