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Symptoms of TMD and the Effects of Ultrasonic Therapy: a Preliminary Clinical Investigation

Purpose: The purpose of this study was to establish the application criteria for ultrasonic therapy in temporomandibular disorders.Methods: By using the continuous sampling method, 20 patients were selected from among the patients in whom ultrasonic therapy was indicated by the attending dentist. Prior to ultrasonic therapy, each patient was examined for the presence or absence of 4 symptoms, namely, spontaneous pain and tenderness in the masseter muscle, pain upon jaw opening, and tenderness in the temporomandibular joint. The degree of discomfort experienced by the patients was measured on the Visual Analog Scale (VAS). Ultrasonic therapy was administered on the bilateral temporomandibular joints and masseter regions 3 times at 5-day intervals. The patients reported the VAS values again at 5 days after the third session of ultrasound irradiation. All patients were divided into two groups—responders and nonresponders. Patients who showed a decrease in the VAS values following the therapy were considered as responders, whereas those who did not show a decrease were considered as nonresponders. The relationship between the presence or absence of any favorable therapeutic response and each pretreatment symptom was statistically assessed using Fisher’s exact test. Intergroup comparison of pretreatment VAS values was performed using Welch’s t test.Results: Therapeutic responses were observed in 16 patients. Analysis of the data revealed that none of the pretreatment symptomatological factors were significantly related to the presence or absence of a clinical response to ultrasonic therapy, although there was a tendency for higher pretreatment VAS values in the nonresponders than in the responders.Conclusion: The results indicate that a response to ultrasonic therapy cannot be predicted based on the assessment of the abovementioned 4 symptoms and the degree of discomfort.