Evaluation of Plain Ultrasound Therapy versus Diclofenac Phonophoresis for the management of Temporomandibular Joint Disorders

Mohamed Faızal Asan; Shruthi Hegde; Vıdya Ajıla

doi:10.7126/cumudj.1383141

EN

Evaluation of Plain Ultrasound Therapy versus Diclofenac Phonophoresis for the management of Temporomandibular Joint Disorders

Abstract

Objective: Temporomandibular joint disorders (TMD) are one of the most common causes of Chronic orofacial pain. Management of TMD includes various invasive and non-invasive methods. The present study was undertaken to compare the efficacy of plain ultrasound therapy and 1% diclofenac gel phonophoresis in the management of TMDs. Materials and Methods: 50 subjects with pain in the TMJ region, falling in Research Diagnostic Criteria (Group I and II) for TMJ disorders and in the age group of 18-40 years were included in the study. Subjects were divided into 2 groups by simple randomization. Group A comprised of 25 Subjects who received plain Ultrasound therapy, while Group B comprised of 25 Subjects who received Diclofenac gel Phonophoresis. All the study subjects were asked to refrain from consuming any other analgesics and muscle relaxants until the completion of six sessions over a period of two weeks. Pre and Post treatment assessment of the subjects was carried out using visual analogue scale (VAS) for TMJ pain, Maximum Mouth opening (MMO) and Helkimo clinical dysfunctional Index (HI). Recurrence within a period of 3 months was recorded in both groups. Results: Intergroup comparisons of VAS, HI and MMO between pre and post treatment were analysed using Independent t-tests. The difference in the mean pre (T1) and post (T2) treatment pain VAS scores and Helkimo index (HI) in both the groups was statistically significant. Group B showed statistically significant reduction in the VAS scores, HI compared to Group A. There was no statistically significant difference in the recurrences among the two groups. Conclusion: The findings of present study showed that 1% Diclofenac phonophoresis was more effective than plain ultrasound therapy with regard to reduction of pain and functional ability of the TMJ.

Keywords

Project Number

not applicable ,

References

1. Murphy MK, MacBarb RF, Wong ME, Athanasiou KA. Temporomandibular disorders: a review of etiology, clinical management, and tissue engineering strategies. Int J Oral Maxillofac Implants 2013;28: e393-414.
2. Talmaceanu D, Lenghel LM, Bolog N, Hedesiu M, Buduru S, Rotar H, et al. Imaging modalities for temporomandibular joint disorders: an update. Clujul Med 2018; 91:280-287.
3. Gauer RL, Semidey MJ. Diagnosis and treatment of temporomandibular disorders. Am Fam Physician 2015; 91:378-386.
4. McNeely ML, Armijo Olivo S, Magee DJ. A systematic review of the effectiveness of physical therapy interventions for temporomandibular disorders. Phys Ther 2006; 86:710-725.
5. Ouanounou A, Goldberg M, Haas DA. Pharmacotherapy in temporomandibular disorders: a review. J Can Dent Assoc 2017; 83:1-8.
6. Wieckiewicz M, Boening K, Wiland P, Shiau YY, Paradowska-Stolarz A. Reported concepts for the treatment modalities and pain management of temporomandibular disorders. J Headache Pain 2015; 16:106.
7. Rai S, Ranjan V, Misra D, Panjwani S. Management of myofascial pain by therapeutic ultrasound and transcutaneous electrical nerve stimulation: A comparative study. Eur J Dent 2016; 10:46-53.
8. Yildirim MA, Öneş K, Gökşenoğlu G. Effectiveness of Ultrasound Therapy on Myofascial Pain Syndrome of the Upper Trapezius: Randomized, Single-Blind, Placebo-Controlled Study. Arch Rheumatol. 2018; 33:418-423.

9. Luksurapan W, Boonhong J. Effects of phonophoresis of piroxicam and ultrasound on symptomatic knee osteoarthritis. Arch Phys Med Rehabil 2013;94:250-255.
10. Dworkin SF, LeResche L, Research diagnostic criteria for temporomandibular disorders: Review, criteria, examinations and specifications, critique. J Cranio mandib Disord 1992;6: 301-355.
11. Ramakrishnan SN, Aswath N. Comparative efficacy of analgesic gel phonophoresis and ultrasound in the treatment of temporomandibular joint disorders. Indian J Dent Res 2019; 30:512-515.
12. Helkimo M. Studies on function and dysfunction of the masticatory system. II. Index for anamnestic and clinical dysfunction and occlusal state. Sven Tandlak Tidskr 1974; 67:101–121.
13. Nokar S, Sadighpour L, Shirzad H, Shahrokhi Rad A, Keshvad A. Evaluation of signs, symptoms, and occlusal factors among patients with temporomandibular disorders according to Helkimo index. Cranio. 2019;37(6):383-388.
14. Sachdeva A, Bhateja S, Arora G, Khanna B, Singh A. Prevalence of temporomandibular joint disorders in patients: An institutional-based study. SRM J Res Dent Sci 2020; 11:123-127.
15. Muthukrishnan A, Sekar GS. Prevalence of temporomandibular disorders in Chennai population. J Indian Acad Oral Med Radiol 2015; 27:508-515.
16. Bagis B, Ayaz EA, Turgut S, Durkan R, Özcan M. Gender difference in prevalence of signs and symptoms of temporomandibular joint disorders: a retrospective study on 243 consecutive patients. Int J Med Sci. 2012; 9:539-544.
17. Nair P, Hedge K, Chatterjee R, Srivastava H, Lalwani R, Patel R. Prevalence of type of temporomandibular disorders in dental OPD patients-a cross sectional study. IOSR J Dent Med Sci 2018; 17:27-31.
18. Wright EF, North SL. Management and treatment of temporomandibular disorders: a clinical perspective. J Man Manip Ther. 2009; 17:247-254.
19. Mena M, Dalbah L, Levi L, Padilla M, Enciso R. Efficacy of topical interventions for temporomandibular disorders compared to placebo or control therapy: a systematic review with meta-analysis. J Dent Anesth Pain Med. 2020 Dec;20(6):337-356.
20. Mason TJ. Therapeutic ultrasound an overview. Ultrason Sonochem 2011; 18:847-852.
21. Saliba S, Mistry DJ, Perrin DH, Gieck J, Weltman A. Phonophoresis and the absorption of dexamethasone in the presence of an occlusive dressing. J Athl Train 2007; 42:349-354.
22. Bhardwaj A, Patra RC, Potale Y, Kumar RM, Khera K, Sanju BS et al. Phonophoresis in Physiotherapy: Mechanisms, Applications, and Emerging Trends for Enhanced Drug Delivery and Therapeutic Efficacy. BIO Web of Conferences 2024; 86: 01031.
23. Dougall AL, Jimenez CA, Haggard RA, Stowell AW, Riggs RR, Gatchel RJ. Biopsychosocial factors associated with the subcategories of acute temporomandibular joint disorders. J Orofac Pain 2012; 26:7-16.
24. Morse JM. Using qualitative methods to access the pain experience. Br J Pain 2015; 9:26-31.
25. Hjermstad MJ, Fayers PM, Haugen DF, Caraceni A, Hanks GW, Loge JH et al; European Palliative Care Research Collaborative (EPCRC). Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manage 2011; 41:1073-1093.
26. Di Rienzo Businco L, Di Rienzo Businco A, D'Emilia M, Lauriello M, Coen Tirelli G. Topical versus systemic diclofenac in the treatment of temporo-mandibular joint dysfunction symptoms. Acta Otorhinolaryngol Ital 2004; 24:279-283.
27. Fernandez-Cuadros M E, Casique Bocanegra L O, Albaladejo-Florin M J, Alava-Rabasa S, Perez-Moro O S. Effect of Diclofenac Gel Phonophoresis on Temporomandibular Joint Disorders: A Prospective Quasi-Experimental Study, Middle East J Rehabil Health Stud. Online ahead of Print; 7(3): e102928.
28. Sequeira J, Girishan T. The effect of therapuetic ultrasound and phonophoresis on tmj pain. International journal of scientific research 2020; 9:35-37.
29. Alonso-Royo R, Sánchez-Torrelo CM, Ibáñez-Vera AJ, Zagalaz-Anula N, Castellote-Caballero Y, Obrero-Gaitán E et al. Validity and Reliability of the Helkimo Clinical Dysfunction Index for the Diagnosis of Temporomandibular Disorders. Diagnostics (Basel)2021; 11:472.
30. Handa R, Sunil M K, Gupta C, Raina A, Khan T, Gulzar A. Efficacy of ultrasound massage therapy as an adjuvant pain control modality in TMDs: A clinical study. J Indian Acad Oral Med Radiol 2018; 30:107-109.
31. Watson T. Ultrasound in contemporary physiotherapy practice. Ultrasonics 2008; 48:321-329.
32. Vijayalakshmi KR, Khan M, Rajguru P. Phonophoresis in temporomandibular joint disorders: A clinical trial. Journal of Advanced Clinical and Research Insights 2015; 2:259-264.
33. Chantaracherd P, John MT, Hodges JS, Schiffman EL. Temporomandibular joint disorders' impact on pain, function, and disability. J Dent Res 2015; 94:79S-86S.
34. Wieckiewicz M, Boening K, Wiland P, Shiau YY, Paradowska-Stolarz A. Reported concepts for the treatment modalities and pain management of temporomandibular disorders. J Headache Pain 2015; 16:106.

Details

Primary Language

English

Subjects

Dental Therapeutics, Pharmacology and Toxicology , Oral Medicine and Pathology

Journal Section

Research Article

Authors

Mohamed Faızal Asan
0000-0001-9747-1914
India

Shruthi Hegde ^*
0000-0002-0744-5593
India

Vıdya Ajıla
0000-0002-5744-9322
India

Publication Date

June 30, 2024

Submission Date

October 31, 2023

Acceptance Date

April 8, 2024

Published in Issue

Year 2024 Volume: 27 Number: 2

DOI

https://doi.org/10.7126/cumudj.1383141

IZ

https://izlik.org/JA85RK99LZ

Cite

RIS / Bibtex

EndNote

Faızal Asan M, Hegde S, Ajıla V (June 1, 2024) Evaluation of Plain Ultrasound Therapy versus Diclofenac Phonophoresis for the management of Temporomandibular Joint Disorders. Cumhuriyet Dental Journal 27 2 85–91.

Evaluation of Plain Ultrasound Therapy versus Diclofenac Phonophoresis for the management of Temporomandibular Joint Disorders

Abstract

Keywords

Öz

Project Number

References

Details

Primary Language

Subjects

Journal Section

Authors

Publication Date

Submission Date

Acceptance Date

Published in Issue

DOI

IZ

Cite