engleski

Physical treatment of temporomandibular joint pain in patients with various bone mineral statuses

Background and aims. The bone mineral density (BMD) of patients with temporomandibular joint (TMJ) disorder was analyzed. Methods. Clinical examination and magnetic resonance imaging as a gold standard was used in the TMJ diagnostics. 35 female patients (mean age 59 years, range 28 – 78) with TMJ disorder (disc displacement, osteoarthritis) underwent physical therapy. Clinical symptomatology included pathological sounds (clicking, crepitation) and/or pain in the TMJs (measured by visual-analogue scale (VAS) 0-10) with one-year follow-up after the beginning of treatment. Apart from the body mass index (BMI in kg/m2), due to medical indications, BMD (in g/cm2) was measured in the lumbar and femoral area by means of dual-energy x-ray absorptiometry. Results. From the total number of patients, 9 of them (25.7%) had normal BMD, 18 (51.4%) had osteopenia and 8 (22.9%) had osteoporosis. Physical therapy significantly reduced pain intensity (p<0.001) before/after physical therapy (mean values on VAS for mouth opening 6.4/2.0 ; rest position 2.7/0.6, and on palpation of TMJ 3.8/1.7). BMI was different in subgroups of patients (p=0.015): patients with osteoporosis had the lowest values (21.73), and those with normal BMD had the value of 26.93. Only 48.58% of patients considered physical therapy successful while the rest felt the pain intensity in the TMJ was the same or even worse but without significant differences between subgroups (p>0.05). Conclusions. Densitometry is not a standard examination procedure within TMJ diagnostics and therefore the sample is rather small. Physical therapy can significantly reduce pain but it does not depend on patients’ BMI.

temporomandibular joint; physicomedical therapy; densitometry; magnetic resonance imaging

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