A COMPARISON OF MANUAL THERAPY AND SPLINT THERAPY IN PATIENTS DIAGNOSED WITH MYOFASCIAL TEMPOROMANDIBULAR DYSFUNCTION WITH SLEEP BRUXISM

Abstract

Purpose: The aim of this study was to examine the effect of manual therapy on temporomandibular pain, range of motion, functionality level of the jaw, sleep quality, and patient satisfaction, and to compare the efficacy with splint therapy among female patients with myofascial temporomandibular dysfunction (M-TMD) accompanied by sleep bruxism (SB). Methods: A total of 29 female patients, aged 18-50 years, diagnosed with M-TMD were separated into two groups using a simple random sampling method as the manual therapy group (MT; n:15) and the splint therapy group (ST; n:14). All the patients were informed about bruxism and its effects and were given home exercises. The patients in the ST group were instructed to use a static splint for one month. The MT group patients received a total of 8 sessions, 45 minutes twice a week of treatment, including joint and soft tissue mobilizations to the temporomandibular joint (TMJ) and cervical region. Pain severity, symptoms, TMJ range of motion, jaw functionality, sleep quality, and patient satisfaction were evaluated. The evaluations were repeated after 4 weeks and compared with baseline values. Results: A statistically significant difference was determined in both groups in pain, TMJ range of motion, and sleep quality (p<0.05). In the comparison between the groups after treatment, the pain, TMJ range of motion values, and sleep quality were seen to be statistically significantly better in the MT group (p<0.05). The patient satisfaction measurements of mean general satisfaction, interpersonal attitude, mean healthcare services score, and general satisfaction total points were found to be statistically significant in the MT group (p<0.05). Conclusion: The applications of both MT and ST were seen to be effective in patients with M-TMD with bruxism. In the comparisons between the groups, the MT method was seen to be more effective than ST. It can be thought that the application of stabilization splint therapy together with manual therapy would significantly increase the treatment efficacy in patients with M-TMD.

Keywords

• Bruxism
• Manual Therapy
• Pain
• Splint
• Temporomandibular Dysfunction

UYKU BRUKSİZMİ OLAN MİYOFASYAL TEMPOROMANDİBULAR DİSFONKSİYON TANILI HASTALARDA MANUEL TEDAVİ İLE SPLİNT TEDAVİSİNİN KARŞILAŞTIRILMASI

Öz

Amaç: Çalışmada, uyku bruksizmin (SB) eşlik ettiği myofasyal temporomandibular disfonksiyonu (M-TMD) olan kadın hastalarda, manuel tedavinin temporomandibular ağrı, eklem açıklığı, çenenin fonksiyonellik düzeyi, uyku kalitesi ve hasta memnuniyeti üzerine etkisini incelemek ve splint tedavisi ile etkinliğini karşılaştırmak amaçlandı. Yöntem: M-TMD tanılı, 18-50 yaş arası 29 kadın hasta, basit rastgele örnekleme yöntemi ile Manuel Tedavi (MT; n:15) ve Splint Tedavi (ST; n:14) olarak iki gruba ayrıldı. Tüm hastalara bruksizm ve etkileri üzerine eğitim ve ev egzersizi verildi. ST grubundaki bireylerden stabilizasyon splintini bir ay süre ile kullanmaları istendi. MT grubuna, temporomandibular eklem (TME) ve servikal bölgeye eklem ve yumuşak doku mobilizasyonlarını içeren haftada 2 seans 45 dk süreyle, toplam 8 seans tedavi uygulandı. Ağrı şiddeti, semptomlar, TME açıklığı, çene fonksiyonellik düzeyi, uyku kalitesi ve hasta memnuniyeti değerlendirildi. Değerlendirmeler 4 hafta sonunda tekrarlandı ve tedavi öncesi bulgular ile karşılaştırıldı. Sonuçlar: Her iki grupta kendi içinde ağrı, TME hareket açıklığı ve uyku kalitesinde istatistiksel olarak anlamlı fark bulundu (p<0,05). Grupların karşılaştırılmasında ağrı, TME hareket açıklığı değerleri ile uyku kalitesinde MT grubu lehine anlamlı sonuçlar alındı (p<0,05). Hasta memnuniyet ölçümlerinde, genel memnuniyet, kişilerarası tutum, sağlık hizmetleri skor ortalaması ile genel memnuniyet total puanı MT grubu bireylerinde anlamlı olarak daha yüksek bulundu (p<0,05). Tartışma: MT ve ST uygulamaları bruksizmin eşlik ettiği M-TMD’si olan hastalarda etkili bulundu, ancak grupların karşılaştırılmasında MT yönteminin ST’ye göre daha etkili olduğu tespit edildi. M-TMD’u olan hastalarda splint tedavisi ile manuel tedavinin birlikte uygulanması tedavi etkinliğini önemli ölçüde arttırabilir.

Anahtar Kelimeler

• Bruksizm
• Manuel Terapi
• Ağrı
• Splint
• Temporomandibular Disfonksiyon

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