Treatment of Temporomandibular Joint Disorders by Ultrashort Wave and Extracorporeal Shock Wave: A Comparative Study

Wenyan Li, Junying Wu, Wenyan Li, Junying Wu

Abstract

BACKGROUND This study was carried out to compare the therapeutic efficacy of extracorporeal shock wave (ESW) and ultrashort wave (UW) for temporomandibular joint disorder (TMD). MATERIAL AND METHODS A total of 80 patients with myofascial pain and TMD were enrolled in this study. The subjects were randomized to receive ESW or UW treatments. Patients in the ESW group received 1 ESW treatment for 4 weeks and patients in the US group were given US treatment once a day for 5 days per week for 4 weeks. The pain was measured using visual analog scale (VAS) and mouth opening was determined as pain-free maximum mouth opening (MMO) before and 4 weeks after the treatments. Other parameters assessed included functional indexes of temporomandibular joint such as mandibular movement (MM), joint noise (JN), joint press (JP), and disability index (DI). RESULTS After therapy, VAS, MMO, MM, JN, JP, and DI in ESW group, and VAS in UW group were significantly improved (P<0.05) as compared to before therapy. VAS, MMO, and the functional indexes of temporomandibular joint in the ESW group were significantly better than those in the UW group (1.79 vs. 2.00, 3.23 vs. 2.03, 1.79 vs. 2.41, 1.45 vs. 2.27, 1.55 vs. 2.59, and 3.30 vs. 4.79, respectively. P<0.05). CONCLUSIONS ESW significantly reduces pain and improves the functional indexes of temporomandibular joint and mouth opening limit for TMD patients as compared with UW therapy.

Conflict of interest statement

Conflict of interests

None.

References

    1. De Leeuw R, Klasser GD. Orofacial pain: Quidelines for assessment, diagnosis, and management. Quintessence; Chicago: 2008.
    1. Kothari SF, Baad-Hansen L, Oono Y, et al. Somatosensory assessment and conditioned pain modulation in temporomandibular disorders pain patients. Pain. 2015;156:2545–55.
    1. Bae Y, Park Y. The effect of relaxation exercises for the masticator muscles on temporomandibular joint dysfunction (TMD) J Phys Ther Sci. 2013;25:583–86.
    1. Rashid A, Matthews NS, Cowgill H. Physiotherapy in the management of disorders of the temporomandibular joint – perceived effectiveness and access to services: A national United Kingdom survey. Br J Oral Maxillofac Surg. 2013;51:52–57.
    1. Sturdivant J, Fricton JR. Physical therapy for temporomandibular disorders and orofacial pain. Curr Opin Dent. 1991;1:485–96.
    1. Zhao Y. [Treatment of temporomandibular joint disorders using acupuncture combined with Chinese and Western medicine]. Journal of Traditional Chinese Medicine. 2011;29:1681–82. [in Chinese]
    1. Notarnicola A, Moretti B. The biological effects of extracorporeal shock wave therapy (eswt) on tendon tissue. Muscles Ligaments Tendons J. 2012;2:33–37.
    1. Mattyasovszky SG, Langendorf EK, Ritz U, et al. Exposure to radial extracorporeal shock waves modulates viability and gene expression of human skeletal muscle cells: A controlled in vitro study. J Orthop Surg Res. 2018;13:75.
    1. Saggini R, Di Stefano A, Saggini A, et al. Clinical application of shock wave therapy in musculoskeletal disorders: Part I. J Biol Regul Homeost Agents. 2015;29:533–45.
    1. Schenk I, Vesper M, Nam VC. [Initial results using extracorporeal low energy shockwave therapy ESWT in muscle reflex-induced lock jaw]. Mund Kiefer Gesichtschir. 2002;6:351–55. [in German]
    1. Dworkin SF. Research diagnostic criteria for temporomandibular disorders: Current status & future relevance. J Oral Rehabil. 2010;37:734–43.
    1. John MT, Dworkin SF, Mancl LA. Reliability of clinical temporomandibular disorder diagnoses. Pain. 2005;118:61–69.
    1. Heller GZ, Manuguerra M, Chow R. How to analyze the Visual Analogue Scale: Myths, truths and clinical relevance. Scand J Pain. 2016;13:67–75.
    1. Walker N, Bohannon RW, Cameron D. Discriminant validity of temporomandibular joint range of motion measurements obtained with a ruler. J Orthop Sports Phys Ther. 2000;30:484–92.
    1. Fricton JR, Schiffman EL. Reliability of a craniomandibular index. J Dent Res. 1986;65:1359–64.
    1. Fricton JR, Schiffman EL. The craniomandibular index: Validity. J Prosthet Dent. 1987;58:222–28.
    1. Calixtre LB, Grüninger BL, Haik MN, et al. Effects of cervical mobilization and exercise on pain, movement and function in subjects with temporomandibular disorders: A single group pre-post test. J Appl Oral Sci. 2016;24:188–97.
    1. Liu F, Steinkeler A. Epidemiology, diagnosis, and treatment of temporomandibular disorders. Dent Clin North Am. 2013;57:465–79.
    1. Gauer RL, Semidey MJ. Diagnosis and treatment of temporomandibular disorders. Am Fam Physician. 2015;91:378–86.
    1. Mao Z, Zhang Z. [Advance on treatment of termporomandibular disorders]. Chin J Stomatol. 2012;47:2–5. [in Chinese]
    1. Schmitz C, Császár NBM, Milz S, et al. Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: A systematic review on studies listed in the PEDro database. Br Med Bull. 2015;116:115–38.
    1. Sabeti-Aschraf M, Dorotka R, Goll A, et al. Extracorporeal shock wave therapy in the treatment of calcific tendinitis of the rotator cuff. Am J Sports Med. 2005;33:1365–68.
    1. Cheng J, Wang Y, Wang Z, et al. Differential regulation of proteoglycan-4 expression by IL-1alpha and TGF-beta1 in rat condylar chondrocytes. Tohoku J Exp Med. 2010;222:211–18.
    1. Kou XX, Wu YW, Ding Y, et al. 17beta-estradiol aggravates temporomandibular joint inflammation through the NF-kappaB pathway in ovariectomized rats. Arthritis Rheum. 2011;63:1888–97.
    1. Jiao K, Niu LN, Wang MQ, et al. Subchondral bone loss following orthodontically induced cartilage degradation in the mandibular condyles of rats. Bone. 2011;48:362–71.
    1. Kim YH, Bang JI, Son HJ, et al. Protective effects of extracorporeal shockwave on rat chondrocytes and temporomandibular joint osteoarthritis; preclinical evaluation with in vivo (99m)Tc-HDP SPECT and ex vivo micro-CT. Osteoarthritis Cartilage. 2019;27:1692–701.
    1. Hazan-Molina H, Reznick AZ, Kaufman H, et al. Assessment of IL-1beta and VEGF concentration in a rat model during orthodontic tooth movement and extracorporeal shock wave therapy. Arch Oral Biol. 2013;58:142–50.
    1. Contaldo C, Högger DC, Khorrami Borozadi M, et al. Radial pressure waves mediate apoptosis and functional angiogenesis during wound repair in ApoE deficient mice. Microvasc Res. 2012;84:24–33.
    1. Wang C-J, Wang F-S, Yang KD, et al. Shock wave therapy induces neovascularization at the tendon-bone junction. A study in rabbits. J Orthop Res. 2003;21:984–89.
    1. Mariotto S, Cavalieri E, Amelio E, et al. Extracorporeal shock waves: From lithotripsy to anti-inflammatory action by NO production. Nitric Oxide. 2005;12:89–96.
    1. Park D-S, Kwon DR, Park G-Y, et al. Therapeutic effect of extracorporeal shock wave therapy according to treatment session on gastrocnemius muscle spasticity in children with spastic cerebral palsy: A pilot study. Ann Rehabil Med. 2015;39:914–21.
    1. Visco V, Vulpiani MC, Torrisi MR, et al. Experimental studies on the biological effects of extracorporeal shock wave therapy on tendon models. A review of the literature. Muscles Ligaments Tendons J. 2014;4:357–61.
    1. Hausdorf J, Lemmens MAM, Kaplan S, et al. Extracorporeal shockwave application to the distal femur of rabbits diminishes the number of neurons immunoreactive for substance P in dorsal root ganglia L5. Brain Res. 2008;1207:96–101.
    1. Lin S-F, Chen Y-J, Tu H-P, et al. The effects of extracorporeal shock wave therapy in patients with coccydynia: A randomized controlled trial. PLoS One. 2015;10:e0142475.
    1. Kociuga N, Kociuga J, Woldańska-Okońska M, et al. [Physiotherapeutic proceeding in symptomatic calcaneal spur treatment]. Wiad Lek. 2016;69:758–64. [in Polish]
    1. Straburzyńska-Lupa A, Kornacka A. Ultrasound therapy in the treatment of calcar pedis – own experiences. Ortop Traumatol Rehabil. 2005;7:78–86.

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