TENS THERAPY'S IMPACT ON EMG ACTIVITY AND MOUTH OPENING IN PATIENTS WITH DDWOR
Melike Özbaykal, Elif Kılıç Kitiz, Dr. Sıla Burcu Özer Yağcı, Prof. Duygu Karakış
Gazi University
Introduction
Intra-articular disorders of the temporomandibular joint (TMJ) are an abnormal positional relationship between the disc and the condyle, articular eminence, and articular fossa. The etiology of disc displacement without reduction(DDwoR) is unclear; however, anatomical factors, parafunction, trauma, or hypermobility of the joints have all been reported to play a key role in structural changes to the TMJ, which could result in disc displacements. Clinically, the main symptoms of DDwoR are characterized by TMJ pain and limited mouth opening (“closed lock”), the distance between the upper and lower incisors is less than 40 mm.
Case Description
A 19-year-old male patient was referred to our clinic with a history of pain in the right joint region and limitation of mouth opening. In the clinical examination there was limited mouth opening(28mm) and the limited lateral movement on the effected side. The Visual Analogue Scale (VAS) was taken to determine the severity of the patient's pain and the score was recorded as 9. Joint sounds were examined with Joint Vibration Analyses (BIO-JVA) to evaluate the temporomandibular disorder (TMD). Before the application of occlusal splint, to increase the limited mouth opening and reduce pain. TENS therapy was applied 3 days a week for 40 minutes for 1 month with ULF- TENS device. To evaluate the changes in the activity of masticatory muscles and occlusion, the electromyographic (EMG) activity of the masseter and anterior temporalis muscles and digital occlusal analysis were recorded synchronously. Recordings were performed before, after the first session and 1 month after TENS treatment in clenching, right and left lateral movements.
Discussion
After the treatments, it was observed that the amount of mouth opening of the patient increased and EMG activity of masticatory muscles decreased. The stabilization splint was applied to the patient and the follow-up continued.