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Investigation of the Effects of Different Treatment Approaches in Jaw (Temporomandibular) Joint Disorders

H

Hacettepe University

Status

Active, not recruiting

Conditions

Temporomandibular Disorders (TMDs)

Treatments

Other: Limbic-Oriented Manual Therapy
Other: Conventional Physiotherapy and Rehabilitation Program

Study type

Interventional

Funder types

Other

Identifiers

NCT07392671
KA-22078

Details and patient eligibility

About

Temporomandibular joint disorders (TMD) are common conditions that may cause jaw pain, limited jaw movement, and reduced quality of life. Individuals with TMD can also experience neck-related problems, balance impairments, emotional changes, and sleep disturbances.

This interventional study aims to investigate the effects of a combined physiotherapy and rehabilitation program in individuals with temporomandibular joint dysfunction. The intervention consists of conventional manual therapy techniques applied to the temporomandibular joint and cervical region, combined with specific manual therapy techniques targeting the limbic system, along with therapeutic exercise applications.

The study will evaluate the effects of this combined treatment approach on pain, jaw range of motion, joint position sense, balance, emotional status, patient satisfaction, and quality of life and sleep in individuals with TMD.

Full description

Temporomandibular joint dysfunction is a complex condition that affects the masticatory system and is frequently associated with cervical musculoskeletal impairments, altered sensorimotor control, and psychosocial factors. In addition to local biomechanical dysfunctions, individuals with temporomandibular disorders may experience changes in pain processing, emotional regulation, balance, and overall quality of life. These factors highlight the need for a comprehensive rehabilitation approach that addresses both peripheral and central mechanisms.

Physiotherapy and rehabilitation interventions for temporomandibular joint dysfunction traditionally focus on the temporomandibular joint and cervical region using manual therapy techniques and therapeutic exercises. While these approaches are effective in improving physical impairments, emerging evidence suggests that central mechanisms, including the limbic system, may influence pain perception, emotional status, and functional outcomes in individuals with temporomandibular disorders.

This interventional study is designed to investigate the effects of a combined physiotherapy and rehabilitation approach that integrates conventional manual therapy techniques applied to the temporomandibular joint and cervical region with specific manual therapy techniques oriented toward the limbic system, along with therapeutic exercise applications. The combined approach aims to address musculoskeletal, sensorimotor, and emotional components of temporomandibular joint dysfunction within a holistic rehabilitation framework.

Participants diagnosed with temporomandibular joint dysfunction will undergo the intervention program and will be evaluated before and after the treatment period. The study focuses on changes in pain, jaw function, sensorimotor control, balance, emotional status, patient satisfaction, and quality of life and sleep, providing a multidimensional assessment of treatment effects.

By examining the outcomes of this combined intervention, the study seeks to enhance the understanding of integrative physiotherapy strategies in the management of temporomandibular joint dysfunction and to support the development of more comprehensive rehabilitation approaches that consider both physical and emotional aspects of the condition.

Enrollment

60 patients

Sex

All

Ages

18 to 60 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Aged between 18 and 60 years

Diagnosed with temporomandibular joint dysfunction (TMD - disc displacement or degenerative joint disease) by an Oral and Maxillofacial Surgery specialist

Clinical findings consistent with temporomandibular joint dysfunction

Presence of symptoms and pain related to TMD for at least 6 months

No history of acute trauma, infection, or neurological disease

No limitation of joint range of motion in the angles assessed for joint position sense

No history of any treatment or physiotherapy for TMD within the last 6 months

Not using occlusal splints, orthodontic appliances, and/or medications for pain

Use of no more than one fixed prosthetic restoration (bridge or implant-supported crown) in a single region

Voluntary participation and provision of written informed consent

Exclusion criteria

History of jaw and/or cervical region surgery or trauma within the last 6 months

Presence of rheumatological or psychiatric disorders

History of fracture involving the temporomandibular joint, cervical, or upper thoracic region

Presence of acute cervical disc pathology or other acute conditions affecting the cervical region

Presence of skin infection or open wounds

Presence of perceptual or communication disorders

Partial edentulism classified as Kennedy Class I, II, or III, or multiple missing teeth that impair masticatory function, except for single-tooth loss

Presence of fixed prosthetic restorations for more than one missing tooth

Use of removable partial or complete dentures

Unwillingness to participate in the study

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Single Blind

60 participants in 2 patient groups

Conventional Manual Therapy + Exercise Program
Active Comparator group
Description:
Participants in this arm receive a conventional physiotherapy and rehabilitation program consisting of manual therapy applied to the temporomandibular joint and cervical region, supervised therapeutic exercises, and a structured home exercise program. No limbic-oriented manual therapy techniques are included in this arm.
Treatment:
Other: Conventional Physiotherapy and Rehabilitation Program
Conventional Program + Limbic-Oriented Manual Therapy
Experimental group
Description:
Participants in this arm receive the same conventional physiotherapy and rehabilitation program, including temporomandibular joint and cervical manual therapy, supervised therapeutic exercises, and a home exercise program, with the addition of limbic-oriented manual therapy techniques aimed at modulating central pain processing and emotional regulation.
Treatment:
Other: Conventional Physiotherapy and Rehabilitation Program
Other: Limbic-Oriented Manual Therapy

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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