Assessment of the effectiveness of osteopathic correction methods and TENS therapy for patients with temporomandibular joint dysfunction

Introduction. The temporomandibular joint dysfunction is an extremely topical issue. According to various authors, the prevalence of temporomandibular joint dysfunction (TMJD) ranges from 28% to 80% depending on the study cohorts, clinical manifestation options, and diagnostic criteria. A significant part of patients are middle-aged people. There is currently no single approach and protocol for the treatment of patients with temporomandibular joint dysfunction in dental practice. Since the temporomandibular joint is also one of the postural sensors that affect the position of the whole body in space, the dysfunction will inevitably affect not only the tone of the masticatory muscles but also the muscles in other parts (primarily in the cervical region) and the state and functioning of the entire musculoskeletal system. This fact determines the appropriateness of osteopathic correction of TMJD, since specialists are very often faced with muscle hypertonicity in dental practice, and the combined treatment of dentists and osteopathy physicians can be more effective than if they treat separately. Transcutaneous electroneurostimulation (TENS) is one of the treatment methods that is applied in dentistry to deprogram masticatory muscles in case of their chronic hypertonicity. This method evokes a clinically evident sensation of muscle relaxation in patients by stimulating muscles with an electric current along the branches of the trigeminal and facial nerves. Objective. Objective assessment of the effectiveness of osteopathic correction of patients with temporomandibular joint dysfunction. Materials and methods. The study involved 30 people diagnosed with temporomandibular joint dysfunction, of which men and women were approximately equal in number. Patients were divided into three equal groups by simple randomization. Patients in the main group 1 (TENS) underwent 3-4 sessions of TENS therapy once a week. For patients of the main group 2 (osteo) the treatment duration was 1 month, on average, during which 2-4 osteopathic correction sessions were performed. Patients in the control group underwent an initial examination and a second examination after 4 weeks. Results. The results obtained indicate the effectiveness of osteopathic correction of patients with TMJD. In addition to the elimination of somatic dysfunctions, the negative dynamics of objective indicators in the control group is noteworthy, which indicates an active process of negative changes in patients with the untreated TMJD. Osteopathic correction makes it possible to treat both lateral and medial pterygoid muscles, which leads to a comprehensive harmonization of lateral movements of the lower jaw and a more pronounced increase (compared to TENS therapy) in the amplitude of mouth opening. And also, due to the elimination of somatic dysfunctions associated with TMJD, it leads to a more pronounced improvement in the general well-being of patients. Conclusion. TMJD is a long-term developing condition that, if untreated, has negative dynamics and is not eliminated itself. It also features the absence of direct correlation of complaints, objective findings and somatic dysfunctions. Osteopathic correction is effective for patients with TMJD.