Telemonitoring for TMD-Related Pain
Structured Telemonitoring as an Adjunct to Conservative Management of Temporomandibular Disorder-Related Orofacial Pain: A Randomized Clinical Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
CZ
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Catanzaro, CZ, Italy, 88100
- Magna Graecia University of Catanzaro
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adults aged 18-80 years.
- Diagnosis of temporomandibular disorder (TMD) according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD).
- Presence of chronic orofacial pain persisting for more than 30 days.
- Diagnosis of myofascial pain involving the masticatory muscles, with or without headache attributed to TMD.
- Ability to use a mobile device compatible with telemonitoring procedures.
Exclusion Criteria:
- Systemic diseases affecting pain perception or neuromuscular function (including autoimmune, neurological, or neoplastic disorders).
- History of severe orofacial trauma.
- Previous major temporomandibular joint surgery.
- Ongoing orthodontic treatment.
- Current use of occlusal splints.
- Current use of muscle relaxants or psychoactive medications.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Telemonitoring group (TG)
The TG received an active management protocol consisting of standard myofascial therapy combined with monthly in-office clinical evaluations and weekly structured remote interactions.
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Weekly remote monitoring through text messaging and scheduled video consultations, in addition to standard conservative management.
|
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Active Comparator: Control group (CG)
CG received conventional care based on monthly in-office clinical follow-up and standard therapeutic instructions without any form of remote monitoring.
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Behavioural counselling, habit reversal training, and home-based self-management exercises with monthly in-office follow-up.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Maximum pain-free mouth opening (mm)
Time Frame: Baseline (T0), 3 months (T1), and 9 months (T2)
|
Change in maximum pain-free mouth opening measured in millimetres (mm) as an indicator of mandibular functional improvement.
|
Baseline (T0), 3 months (T1), and 9 months (T2)
|
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Mandibular lateral excursions (mm)
Time Frame: Baseline (T0), 3 months (T1), and 9 months (T2)
|
Change in right and left mandibular lateral excursion measured in millimetres (mm).
|
Baseline (T0), 3 months (T1), and 9 months (T2)
|
|
Protrusive movement (mm)
Time Frame: Baseline (T0), 3 months (T1), and 9 months (T2)
|
Change in maximum mandibular protrusive movement measured in millimetres (mm).
|
Baseline (T0), 3 months (T1), and 9 months (T2)
|
|
Pain intensity assessed using the Visual Analogue Scale (VAS)
Time Frame: Baseline (T0), 3 months (T1), and 9 months (T2)
|
Change in perceived pain intensity assessed using a 10-cm Visual Analogue Scale (VAS), where higher scores indicate greater pain intensity.
Scale range is 0 to 10.
|
Baseline (T0), 3 months (T1), and 9 months (T2)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Oral Behaviours Checklist (OBC) score
Time Frame: Baseline (T0), 3 months (T1), and 9 months (T2)
|
Change in the frequency of oral parafunctional behaviours assessed using the Oral Behaviours Checklist (OBC).
Higher scores indicate a greater frequency of reported oral behaviours.
Scale range is 0 to 84.
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Baseline (T0), 3 months (T1), and 9 months (T2)
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: SELENE BARONE, PhDs, DDS, Magna Graecia University of Catanzaro
Publications and helpful links
General Publications
- Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, List T, Svensson P, Gonzalez Y, Lobbezoo F, Michelotti A, Brooks SL, Ceusters W, Drangsholt M, Ettlin D, Gaul C, Goldberg LJ, Haythornthwaite JA, Hollender L, Jensen R, John MT, De Laat A, de Leeuw R, Maixner W, van der Meulen M, Murray GM, Nixdorf DR, Palla S, Petersson A, Pionchon P, Smith B, Visscher CM, Zakrzewska J, Dworkin SF; International RDC/TMD Consortium Network, International association for Dental Research; Orofacial Pain Special Interest Group, International Association for the Study of Pain. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Groupdagger. J Oral Facial Pain Headache. 2014 Winter;28(1):6-27. doi: 10.11607/jop.1151.
- Manfredini D, Lombardo L, Siciliani G. Temporomandibular disorders and dental occlusion. A systematic review of association studies: end of an era? J Oral Rehabil. 2017 Nov;44(11):908-923. doi: 10.1111/joor.12531. Epub 2017 Jul 2.
- Ohrbach R, Dworkin SF. The Evolution of TMD Diagnosis: Past, Present, Future. J Dent Res. 2016 Sep;95(10):1093-101. doi: 10.1177/0022034516653922. Epub 2016 Jun 16.
- Ben El Hammi N, Amessegher F, Moudni S, Jouhadi EM. Physiotherapy Approaches for Temporomandibular Disorders: A Multimodal Conservative Management Strategy. Cureus. 2025 Jul 28;17(7):e88885. doi: 10.7759/cureus.88885. eCollection 2025 Jul.
- Iodice G, Michelotti A, D'Anto V, Martina S, Valletta R, Rongo R. Prevalence of psychosocial findings and their correlation with TMD symptoms in an adult population sample. Prog Orthod. 2024 Oct 14;25(1):39. doi: 10.1186/s40510-024-00538-y.
- Ohrbach R, Michelotti A. The Role of Stress in the Etiology of Oral Parafunction and Myofascial Pain. Oral Maxillofac Surg Clin North Am. 2018 Aug;30(3):369-379. doi: 10.1016/j.coms.2018.04.011. Epub 2018 Jun 1.
- Sycinska-Dziarnowska M, Maglitto M, Wozniak K, Spagnuolo G. Oral Health and Teledentistry Interest during the COVID-19 Pandemic. J Clin Med. 2021 Aug 11;10(16):3532. doi: 10.3390/jcm10163532.
- Saini RS, Chopra S, Assiri YA, Alhamoudi FH, Vaddamanu SK, Chaturvedi M, Kuruniyan MS, Banakar M, Heboyan A. Impact of mHealth and eHealth on oral health literacy: A systematic review. Digit Health. 2025 Jul 21;11:20552076251360955. doi: 10.1177/20552076251360955. eCollection 2025 Jan-Dec.
- Peck CC, Goulet JP, Lobbezoo F, Schiffman EL, Alstergren P, Anderson GC, de Leeuw R, Jensen R, Michelotti A, Ohrbach R, Petersson A, List T. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders. J Oral Rehabil. 2014 Jan;41(1):2-23. doi: 10.1111/joor.12132.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Pain
- Neurologic Manifestations
- Musculoskeletal Diseases
- Mouth Diseases
- Stomatognathic Diseases
- Nervous System Diseases
- Muscular Diseases
- Joint Diseases
- Jaw Diseases
- Mandibular Diseases
- Cranial Nerve Diseases
- Craniomandibular Disorders
- Facial Nerve Diseases
- Pathological Conditions, Signs and Symptoms
- Signs and Symptoms
- Temporomandibular Joint Disorders
- Facial Pain
- Facial Neuralgia
- Therapeutics
- Conservative Treatment
Other Study ID Numbers
Other Study ID Numbers
- 268/2021
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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