engleski

Physicomedical therapy and topical ketoprofen for pain caused by temporomandibular joint disorder

Introduction. Temporomandibular disorders consist of a disorder of masticatory muscles and/or a disorder of temporomandibular joint (TMJ). The aim of this study was to evaluate the use of physicomedical therapy combined with topical application of Fastum gel® for the treatment of TMJ disorder during an 8-month period. Material & Methods. In the period from September 2008 until May 2009 32 TMD patients were examined (mean age 38.3 years, 93.8% women). The criteria for inclusion were: pain in the TMJ, limited mouth opening and pathologic noise. In collaboration with a rheumatologist-physiatrist, patients went to physicomedical therapy and topically applied Fastum gel®, a non-steroidal anti-inflammatory drug ketoprofen gel. The control group consisted of 20 students of dental medicine (mean age 23.5, 70% women). By means of magnetic resonance imaging the TMJ disorder was confirmed: discopathy (anterior disc displacement) in 25 (78.1%) and osteoarthritis in 7 (21.9%) patients. Results. The most prominent symptom was pain in TMJ in 31 (96.9%) of patients. The median of pain upon mandibular movement was 6 on AVS, 0 at rest, 3.55 during palpation. The median of active mouth opening for patients was 40.75 mm before treatment and 52.25 mm for asymptomatic subjects, which was statistically significant (t-test with p<0.001). The difference in all pain evaluations on AVS scale after the treatment was shown to be statistically significant (t-test with p<0.001): pain upon mandibular movement was 1.1. As much as 81.26% of the patients had no disturbances after treatment or they experienced a significant improvement. Conclusion. One of the efficient reversible and noninvasive modalities for treatment of TMJ disorders is physicomedical therapy. During an 8-month follow up it was shown that a better and mostly painless oral function was achieved. NSAD seems to be a useful complementary therapy of TMJ disorder.

temporomandibular joint; physicomedical therapy; magnetic resonance imaging

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