M.Tech. / Purpose: Many diseases are very complex and this is especially true with temporomandibular disorders (TMDs). The lack of consensus on the aetiology, signs and symptoms and treatments available makes it extremely difficult for health care practitioners to treat TMDs. A clear definition of the condition itself has not been agreed on between many disciplines involved in the diagnoses and treatment of TMDs. Two competing definitions stand out in current literature. The physical medicine and dental professions define TMDs as various musculoskeletal disorders of the masticatory system. Some authors also stated that most patients with TMDs suffer primarily from a muscular disorder caused by masticatory myofascial trigger points (TrPs). The chiropractic profession defines TMDs as a group of somatic disorders that occur around the structurally integrated craniomandibular system but primarily affects the temporomandibular joint (TMJ) system. The term TMDs recognises that this craniomandibular pathology is a result of dysfunction in any structural area of the head or neck, not only the TMJ. This purpose of this study was to compare an adjustment treatment approach versus a soft tissue approach for the treatment of TMDs. Method: This study consisted of two groups; both the experimental and control groups consisted of 15 participants with TMDs. The participants were between the ages of 18 and 40 years. Potential participants were examined and accepted based on the inclusion and exclusion criteria. The experimental group received adjustments delivered to the TMJ and upper cervical spine, the control group received therapeutic ultrasound (U/S) to the xiv muscles of mastication. Objective and subjective findings were based on the treatments. Procedure: Each participant agreed to 6 treatment sessions and a seventh follow up session over a 4 week period. The participant completed a TMDs Disability Questionnaire. Algometer readings were taken over the masseter and temporalis TrPs bilaterally. Calliper readings measured the range of motion (ROM) of the TMJ, i.e. mandibular depression, protrusion and right and left deviation. The experimental group received adjustments to restricted segments of the TMJ and upper cervical spine as determined by motion palpation. The control group received therapeutic U/S to the masseter and temporalis muscles bilaterally. The same treatment procedures were administered over the study; subjective and objective readings were only taken again at visit 4 and 7. Results: In terms of subjective measurements based on the TMDs Disability Questionnaire scores, a statistically significant difference in the disability, severity and frequency of symptoms within the experimental and control groups individually, as well as the usual symptom intensity level within the control group was revealed. No statistically significant difference in terms of disability, frequency, severity and usual symptom intensity between the two treatment groups over time was revealed. In terms of objective measurements based on algometer readings, a statistically significant difference in the left masseter muscle and right temporalis muscle sensitivity within the experimental group individually was revealed. A statistically significant difference in the left masseter muscle and left temporalis muscle sensitivity within the control group individually was revealed. No statistically significant difference in muscle sensitivity between the groups over time was revealed. However, the control group showed a larger overall clinical significant difference in the masseter and temporalis muscle sensitivity bilaterally.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uj/uj:8788 |
| Date | 09 July 2012 |
| Source Sets | South African National ETD Portal |
| Detected Language | English |
| Type | Thesis |
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