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A prospective randomized study was carried out to evaluate the efficacy of physical therapy in addition to splint therapy on treatment outcome in patients with temporomandibular disorders (TMD) with respect to objective and subjective parameters. Twenty-six patients suffering from an arthrogenic TMD and exhibiting a painfully restricted jaw opening were randomized in two groups. Thirteen patients were treated solely with Michigan splint (group I), 13 patients received supplementary physical therapy (group II). Before treatment a clinical examination and electronic recording of jaw movements were performed and subjective pain level was evaluated by visual analogue scales. After 3 months of therapy maintenance of improvement was evaluated. Within treatment groups comparison of data before and after treatment was analysed using Wilcoxon test. Groups were compared by Mann–Withney- U test. A P-value < 0.05 was considered significant. Compared with the baseline, in both groups mandibular movement capacity increased significantly after treatment, whereas subjective pain decreased significantly ( P < 0.05). Active jaw opening increased from 28.6 ± 5.8 to 35.9 ± 4.8 mm in group I and from 30.1 ± 5.4 to 40.8 ± 4.1 mm in group II. After therapy the difference of active jaw opening between groups was significant ( P < 0.05). Physical therapy also gave a supplementary improvement of protrusive mandibular movement capacity during electronic registration and subjective pain level. For none of these parameters this difference between groups was significant. Physical therapy seems to have a positive effect on treatment outcome of patients with TMD. [ABSTRACT FROM AUTHOR]

It has never been investigated, if mandibular movements of patients with craniomandibular disorders (CMD) result in a lower reproducibility of dynamic functional parameters which are used for the individual articulator setting. The aim of the present study was to compare the reproducibility of electronically registered functional parameters in patients with CMD and in a control group. Dynamic functional parameters were recorded in 30 patients and 30 volunteers with a computerized ultrasound system (ARCUSdigma). The whole registration was performed three times during one session and three times at a second session 1 week later. The horizontal condylar inclination in the patient group gave a standard deviation of 2·17° ± 0·95°, indicating poorer reproducibility than in the volunteer group, for which the standard deviation was 1·37° ± 0·42°. The reproducibility of measurements of the Bennett angle was also poorer in the patient group than in the volunteer group, with standard deviations of 1·70° ± 0·62° and 1·22° ± 0·40°, respectively. The standard deviations calculated for determination of incisal inclination during laterotrusion was 3·02° ± 1·49° for patients and 2·30° ± 1·17° for volunteers. The standard deviations for incisal inclination during protrusion was 2·02° ± 0·95° for patients and 2·06° ± 1·82° for volunteers. The reproducibility of measurement of horizontal condylar inclination, Bennett angle and incisal inclination during laterotrusion therefore showed significantly lower reproducibility in the patient group than in the volunteer group ( P < 0·05). The overall reproducibility of the measurements was nevertheless good in both groups, with standard deviations under 3·1°, so that an individual setting of an articulator seems useful even in patients with CMD. [ABSTRACT FROM AUTHOR]