Efectos craneomandibulares de la técnica articulatoria del cóndilo mandibular en pacientes con patología temporomandibular y dismetría de miembros inferiores

Abstract

Objetives: to assess the changes in maximal mandibular opening (MMO), upper cervical mobility (UCM), pressure pain threshold (PPT) and painful response (PR) to mechanical stimulation in patients with temporomandibular disorders and leg length Inequality, after a combined treatment of suboccipital inhibition (SI) and neuromuscular glide (NG), with or without a mandibular condile mobilization (MCM). Subject and methods: an experimental, longitudinal, prospective, randomised and double-blinded study. The sample composed of 66 subjects, with a mean age of 39 years (standard deviation of 14 years) and a female proportion of 80.3%, was randomly distributed in a control group (n = 29) and an experimental group (n = 37). In the control group, a (SI) manoeuvre was combined with a NG technique on the masseters muscles. A MCM was added to this protocol in the experimental group. As a measurement tool, PPT was assessed on areas where tight bands of masseter and temporalis muscles were located (algometry). Likewise, UCM was measured with a digital inclinometer, MMO with a digital caliper, and PR measured with visual analogic scale (VAS) to mechanical stimulation. Measurements were made before the intervention and inmediately afterwards. Results: the comparison between groups showed clinically relevant differences in MMO, PPT in temporalis and left masseter muscles, and PR to mechanical stimulation measured with VAS in both temporalis muscles. The UCM not show significant changes on experimental group. The PR showed an increase in right masseter of experimental group. Conclusions: The MCM generates clinically relevant changes in MMO, PPT in both temporalis and left masseter muscles, and PR by EVA score of both temporalis. On the other side, the inclusion of MCM does not add changes in MCM and the PR of masseters muscles.