Background: Myogenous temporomandibular disorders (TMD) are considered to be a common
musculoskeletal condition. No studies exist comparing intra-oral myofascial therapies to
education, self-care and exercise (ESC) for TMD. This study evaluated short-term differences
in pain and mouth opening range between intra-oral myofascial therapy (IMT) and an ESC
program.
Methods: Forty-six participants with chronic myogenous TMD (as assessed according to the Research
Diagnostic Criteria Axis 1 procedure) were consecutively block randomised into either an
IMT group or an ESC group. Each group received two sessions per week (for five weeks) of
either IMT or short talks on the anatomy, physiology and biomechanics of the jaw plus
instruction and supervision of self-care exercises. The sessions were conducted at the first
author’s jaw pain and chiropractic clinic in Sydney, Australia. Primary outcome measures
included pain at rest, upon opening and clenching, using an eleven point ordinal self reported
pain scale. A secondary outcome measure consisted of maximum voluntary opening range in
millimetres. Data were analysed using linear models for means and logistic regression for
responder analysis.
Results: After adjusting for baseline, the IMT group had significantly lower average pain for all
primary outcomes at 6 weeks compared to the ESC group (p < 0.001). These differences were
not clinically significant but the IMT group had significantly higher odds of a clinically
significant change (p < 0.045)..There was no significant difference in opening range between
the IMT and ESC groups. Both groups achieved statistically significant decreases in all three
pain measures at six weeks (p ≤ 0.05), but only the IMT group achieved clinically significant
changes of 2 or more points.
Conclusion: This study showed evidence of superiority of IMT compared to ESC over the short-term but
not at clinically significant levels. Positive changes over time for both IMT and ESC
protocols were noted. A longer term, multi-centre study is warranted.
Trial registration: Australian and New Zealand Clinical Trials Registry ACTRN12610000508077.
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