Quantitative Evaluation of Osteopathic Treatment in Temporomandibular Joint Disorders Using Magnetic Resonance Imaging

Study Overview
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Brief Summary
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The aim of this study is to assess the impact of osteopathic manual treatment in patients with an anterior disc displacement over sleep and health quality, pain scores and the movement of the condyle and disc of the temporomandibular joint (TMJ) quantitatively.

Detailed Description
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Patients with TMD will involve to this study. After having the diagnose in Yeditepe U. Dental Hospital patients will be sent to the Radiology Department. MRI images will be gathered in sagittal, coronal and axial plane for each patient before and after treatment. Volunteers will be divided into two groups; (1) splint therapy for 6 weeks, (2) splint therapy + osteopathy 2 times a week for 6 weeks randomly. At the end of the treatment, patients will be sent to Radiology for the second images. Health Survey and pain scores, Disc condyle angle, disc and condyle displacements will be measured and compared inter and intra groups.

Official Title
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Quantitative Evaluation of Osteopathic Treatment in Temporomandibular Joint Disorders Using Magnetic Resonance Imaging

Conditions
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Temporomandibular Disorders, Articular Disc Disorder (Reducing or Non-Reducing), Osteopathy in Temporomandibular Disorders

Intervention / Treatment
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* Other: Occlusal Splint Treatment
* Other: Osteopathic Manual Treatment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: • Clinical diagnosis of TMD (anterior disc displacement) Exclusion Criteria: Active orthodontic treatment Systemic diseases Oral or dental pathologies Dental implant placement Exodontia within 6 months Cranial and cervical trauma or surgery Taking antidepressant medication Contraindication of MRI scans

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Both groups receive splint treatment, but study group also receives osteopathic manual treatment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Control Group<br>Occlusal Splint | Other: Occlusal Splint Treatment<br>* Occlusal splint is used by a dentist during sleep or day time to protect the teeth and temporomandibular joint. Manufactured individually by the technicians according to the dentists measurement procedure.<br>|
| Experimental: Study Group<br>Osteopathic Manuel Therapy | Other: Occlusal Splint Treatment<br>* Occlusal splint is used by a dentist during sleep or day time to protect the teeth and temporomandibular joint. Manufactured individually by the technicians according to the dentists measurement procedure.<br>Other: Osteopathic Manual Treatment<br>* Osteopathy treats the body as a whole and applied by hands over the related structures of the body. TMJ, Cervical, Thoracal, Lumbar vertebra mobilization was applied as well as the fascial and visceral mobilization. Patients also used occlusal splint for 6 weeks during the intervention.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Temporomandibular Joint Pain | 10 point scale 0- no pain 10- severe pain | 6 weeks after the first measurement | 
| Change in TMJ MR images | Disc-condyle angle, disc and condyle positions were measured over TMJ images | 6 weeks after the first measurement | 
| Change in Mandibular Movements | Depression, Left and Right lateralization of the mandibula was measured by the caliper | 6 weeks after the first measurement | 
| Change in Cervical Movement | Cervical Region range of motions was measured by a goniometer | 6 weeks after the first measurement | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in bodily pain | 10 point scale 0- no pain 10- severe pain | 6 weeks after the first measurement | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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temporomandibular disorders, anterior disc displacement with reduction, MRI analyses, Osteopathy