Introduction
TMD, TMD pain, tenderness, temporomandibular joints, pain, orofacial pain, TMJ, Orofacial pain, Skeletal muscle palpation, TMJ disorders, chronic pain, orthodontic, masticatory muscle function
TMJ, GENETIC CONDITION, DISEASE, DISORDERS, TEMPOROMANDIBULAR JOINT DISORDERS, CAVITY, CHRONIC PAIN, DISEASES
Each component of the masticatory system is characterized by a specific structural tolerance, the exceeding of which may lead to tissue damage. Potentially aggravated zones include: masticatory muscles, temporomandibular joints (TMJ), periodontal ligaments and teeth hard tissue [Therapy of temporomandibular disorders (TMD) involves a complex healing process mainly due to the multifactorial etiology of the disease. The etiological factors include genetic conditions, factors located inside the oral cavity and environmental determinants, with particular emphasis on psychoemotional factors that were proven to have a decisive influence on the elevated muscle activity in the masticatory organ [The key in the treatment of TMDis to provide the patient with specialist dental care in order to restore intra-oral homeostasis, counselling in order to diagnose and treat psycho-emotional disorders and physiotherapeutic care, orofacial pain treatment focused on pain elimination, as well as the improvement or restoration of the regular movement pattern within TMJ and adjacent tissues [Due to the type of the therapeutic method used for TMD, procedures applied in the process can be divided into: dental (e.g. occlusal appliances, long-term irreversible prosthetic treatment, orthodontic alignment) [In medical literature, the role of physiotherapy for the recovery of patients with TMD is emphasized [According to the current definition provided by IFOMPT (International Federation of Orthopedic Manipulative Physical Therapists), MT should be understood as: ‘a specialized area of physiotherapy, devoted to the management of neuromuscular-skeletal diseases, based on clinical conclusions and the use of highly specialized methods of treatment, including manual techniques and therapeutic exercises’ [Articular techniques dominated in MT until recently. Currently, it is believed that this way of management is only acceptable in the acute phase, therefore not used for chronic pain [Modern physical therapy makes it possible to apply two physical factors simultaneously [The effectiveness of TMD treatment largely depends on the proper problem assessment and initial diagnosis. Orofacial pain specialist integrates patients’ medical history, physical examination and imaging prior to treatment plan implementation.In order to standardize the diagnostic criteria for TMD, a standardized tool, the Diagnostic Criteria for Temporomandibular Joint Disorders (DC-TMD), was established in 2014. Based on the patient’s signs and symptoms, DC/TMD defines two axes: (i) Axis I, dividing TMD into muscular (Group I) and atherogenic TMD (Groups II and III); Axis II, assessing behavioral and psychological status [Skeletal muscle palpation in standard diagnostic methods allows only for subjective, operator-biased assessment of elevated muscle tension and tenderness to palpation. Currently, thanks to the development of medical physics and biomedical engineering, it is possible to use additional functional diagnostic methods into our advantage, which is considered by many a valuable addition to clinical judgment process and proper patient management. One of the quantitative tools that significantly complement the examination of the masticatory muscle function is surface electromyography - sEMG [The sEMG assessment of masticatory muscle function in people with TMD forms the basis for diagnosing the disease, monitoring its progression and measuring the effectiveness of treatment. Numerous studies have shown that, in patients with TMD, changes in masticatory muscle EMG activity are either due to the disease itself or to a compensatory mechanism related to symptoms [In most up-to-date literature, there are just a few randomized controlled trials (RCTs) comparing the effectiveness of treatment with MT and physical therapy in TMD pain. This prompted the authors to investigate the topic of the analgesic application of manual therapy, magnetostimulation and synergism of physical factors in patients with TMD. Due to the wide variety of symptoms experienced by patients with TMJ disorders, the studies focused on three commonly reported conditions. These include: chronic pain in the masseter muscles (over 3 months), limited mobility of the mandible and a feeling of increased tension in the masseter muscle.We hypothesized that physical and manual therapeutic factors alter the bioelectrical activity of the masseter muscle, which could contribute to the improvement of TMJ mobility. Reducing muscle tension reduces the intensity of the perceived pain.The aim of the study is to test the effectiveness of the manual factors used.and physical exercises in the elimination of pain and increased muscle tension in patients.with TMD. Additionally, the assessment of the influence of the applied forms of therapy on the TMJ range of motion (ROM).