Clinical Research Directory

Cervical Proprioception, Masticatory Pain Threshold and Craniovertebral Angle in TMD

Temporomandibular disorder (TMD) is a group of conditions involving the masticatory muscles, temporomandibular joint (TMJ), and associated structures of the head, neck, and cervical region. TMD may cause pain in the ear region and over the masseter muscle, restricted mandibular movement, and clicking or crepitus sounds in the temporomandibular joint. It may also be accompanied by cervical dysfunction, limited range of motion, pain, and postural abnormalities. Due to the close anatomical and functional relationship between the cervical region and the TMJ, disorders affecting one region are likely to influence the other. Alterations in the TMJ may lead to changes in the cervical spine and consequently affect proprioception. Head posture can be evaluated using the craniovertebral angle. Increases or decreases in this angle may reflect changes in anterior head tilt. Cervical impairments associated with TMD may also result in alterations in the craniovertebral angle. Therefore, the aim of this study is to compare cervical joint position sense, pressure pain threshold of the masticatory muscles, and craniovertebral angle values between individuals with TMD and healthy controls.

Orofacial Pain Self-management: Personality Moderation Effect

The objective of this clinical trial is to study the effect of self-management on pain perception in patients with chronic orofacial pain and temporomandibular disorders (TMD) comparing it with the conventional treatment proposed by the TMD clinical practice guidelines. It also evaluates its effect on function and various psychosocial variables. As a secondary objective, this work proposes to study the variability between patients, in terms of personality factors, as moderators of the effect of treatment on pain perception. Including in the proposed statistical models certain covariates such as perception and/or coping with stress, anxiety and other psychosocial variables. This is a randomized clinical trial with two intervention groups and three measurement times (T0; pre-intervention, T1; post-5 weeks and T2; post-6 months). The experimental group will be applied a protocol based on self-management, which includes: therapeutic education, cognitive-behavioral tools, therapeutic exercise of the temporomandibular region, mind-body strategies and modifications of aspects related to lifestyle. The control group will carry out an intervention program based on the Clinical Practice Guidelines for the Management of Temporomandibular Joint Disorders. Therefore, using a set of tools based on therapeutic education, cognitive-behavioral tools for bruxism and other parafunctional habits, temporomandibular region exercises and manual therapy.

Emotional Release After Trigger Point Needling to Treat Myofascial Pain of the Head and Neck - Prospective Study

Temporomandibular Dysfunction (TMD) as classified by the DC-TMD has a significant psychosocial component referred to as "Axis II". One of the methods of treatment for myofascial TMD is "needing" which could be "dry needling" using only a needle or "wet needling" using local anesthetics. Practitioners of needling commonly observe an emotional release by the patient undergoing needling. This study aims to record and measure the emotional state of patients just before and just after needling for myofascial TMD via questionnaires.