engleski

Physical therapy with topical ketoprofen and anxiety related to temporomandibular joint pain treatment

The aim of this study was to evaluate the level of anxiety and the use of physical therapy combined with topical application of a non-steroidal anti- inflammatory drug ketoprofen gel for the treatment of temporomandibular joint (TMJ) disorder. During an 8-month period, 32 patients were examined (mean age 38.3 years) and went to physical therapy with topically applied Fastum gel. The control group consisted of 20 students of dental medicine (mean age 23.5 years). All subjects were examined by magnetic resonance imaging. The main outcome measuring criteria were: pain intensity rated on a visual-analogue scale, maximal mouth opening capacity, and anxiety evaluated by Spielberger’s State-Trait Anxiety Inventory (STAI 1 - concerning anxiety as subjective state, in a period of last week, including today, and STAI 2 - concerning anxiety as relatively stable individual characteristic). The median of active mouth opening for patients was 40.75 mm before treatment and 52.25 mm for control subjects, which was statistically significant (p<0.001). The difference in all pain evaluations on AVS scale after the treatment was shown to be statistically significant (t-test with p<0.001): pain upon mandibular movement was 1.5, 0.1 at rest and 1.7 during palpation. While there were no differences in anxiety levels of STAI 1 (p=0.0666), there was a statistically significant difference of STAI 2 (p=0.0096). Comparing asymptomatic subjects, their active mouth opening was greater than in patients before (p<0.0001) and after the treatment (p<0.0011). Physical therapy is a recommended modality for TMJ pain treatment. Nevertheless, even immediately after the treatment, the patients had a lower capacity of mouth opening compared to the asymptomatic group.

temporomandibular joint; physical medicine; magnetic resonance imagin

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