Patients' assessment of efficiency of physiotherapeutic treatment modalities in temporomandibular disorders (TMD)

Especially in the last 10 years the aetiological significance of occlusion for TMD was relativated and the search for other alternative therapeutic strategies was intensified. For the treatment of myogenous and arthrogenous problems in TMD different kinds of physiotherapy are reported. Our intention of the present pilot study was focused on patients' perception of efficiency of different physiotherapeutic modalities and in relation to splint therapy. A total of 187 patients of the TMD clinic in Dusseldorf were retrospectively asked to fill out a questionnaire with topics on physiotherapeutic home training programme (HTP), on professional physiotherapy (PP), on splint therapy (ST) and overall assessment of treatment effort (OATE). Eighty-one questionnaires could be analysed and evaluated in relation to three diagnostic TMD subgroups (myogenous, arthrogenous and mixed). The HTP was positively assessed in 74%, PP in 70% and ST only in 38%. Fifty-one per cent of patients could realize HTP regularly per day, 86% of patients could realise PP regularly per week. The majority of patients felt improvement after some weeks/months of HTP resp. PP. No significant relation could be detected between TMD subgroups and patients'assessment to HTP, PP, ST and OATE. Based on patients' assessment the results indicate that physiotherapeutic treatment modalities are highly efficient, whereas a differentiation between mentioned TMD subgroups does not seem to exist. A minority of patients (c. 20–25% of clinical cases) does not respond to dental-occlusal and physiotherapeutic therapy very well. Therefore, a multidisciplinary psychosocial-based treatment approach might be useful in these cases.