Effects of Mandibular Exercises Effect on Pain Perception and Sensitivity in Mandibular Myofascial Pain
Condition: Temporomandibular Disorders
MeSH terms: Temporomandibular Joint Disorders; Temporomandibular Joint Dysfunction Syndrome
Study type: Interventional

Summary: 
      The effectiveness of mandibular exercises as a treatment of muscular Orofacial Pain is yet
      unknown. This study hypothesized that training exercises can be an effective therapy
      improving pain perception.
    

Detailed description: 
      Temporomandibular disorders (TMDs) represent heterogeneous musculoskeletal disorders, where
      most common presentation is mandibular muscle pain, which is also more common among female
      than men. Many interventions have been proposed for this pain control, regarding drugs, oral
      splints, relaxing exercises and self awareness but little is known about mandibular active
      contraction exercises. The aim of this study is to evaluate the effects of mandibular
      exercises in pain perception and sensitivity in women. A double blind randomized clinical
      trial will be conducted among fertile university student women with Oral Contraceptives (OC)
      use -to control hormonal influences-, with report of facial pain and myofascial pain
      diagnosis (RDC/TMD). They will be assessed in Visual analogue scale (VAS), sleep quality,
      Pressure Pain Threshold (PPT) and pressure pain tolerance (PPTol), and then allocated in one
      of the three interventions for 21 days: isometric mandibular active exercises over silicone
      bars; video-guided isotonic mandibular contractions over cloth pegs or counseling about
      disorders nature as passive comparison. After 21 days, VAS, PPT and PPTol in bilateral
      temporalis and masseter muscles will be assessed for a second time,) and compared with
      initial pain status.

      Data will be entered by single blind operator, and will be open for quality auditing. Site
      monitoring will be performed by the University clinical entities.

      Data checks will be also performed as planned. Descriptive and analytical statistics will be
      performed to address the primary and secondary objectives.
    

Intervention name(s): Isometric mandibular exercises; Isotonic mandibular exercises; Counseling group
Intervention type(s): Other; Other; Behavioral
Intervention description(s): daily video guided three-minutes routine in 21 days (days of OC consumption) of soft clenching over three millimeters silicone bars bilaterally on molars; daily video guided three-minutes routine in 21 days (days of OC consumption) of isotonic dynamic contraction over calibrated cloth pegs on central incisors; subjects included in this group get an education brochure about the disorder and receive no further interventions
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Musculoskeletal Pain; Orofacial Pain; Physical Therapy Modalities; Oral Contraceptives; Mandibular Diseases; Muscular Diseases; Risk factors; Contraceptive Usage; Pain, Chronic; Craniomandibular Disorders