Immediate effectiveness of Jog-manipulation technique on the mouth-opening limitation of patients with temporomandibular disorders (TMD)

• Published in: Journal of the Japanese Society for the Temporomandibular Joint Vol. 21; no. 2; pp. 129 - 137
• Main Authors: TOYAMA, Michio, SUGAWARA, Yoshihiro, NAGATA, Kazuhiro, ATSUMI, Yojiro, SHIRONO, Miwa, SAKAI, Motonori, GOTOU, Mototaka
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society for Temporomandibular Joint 2009; 一般社団法人 日本顎関節学会
• Subjects: jaw movement; manipulation; mouth-opening limitation; temporomandibular disorders; マニピュレーション; 開口制限; 顎運動; 顎関節症
• ISSN: 0915-3004; 1884-4308
• DOI: 10.11246/gakukansetsu.21.129

The manipulation technique (MAT) is a non-invasive and inexpensive treatment procedure used for mouth-opening limitations in TMD patients. Although there are various MAT procedures, their effectiveness and the most effective method of application have not been confirmed. Jog-Manipulation (J-MAT) is a combination of three different types of MAT, i.e. the Pivot closing type, Side-to-side type and Opening type, to suit the many types of mouth-opening limitations. The purpose of this study was to clarify the effectiveness of J-MAT and to identify the effect of each step of MAT for mouth-opening limitations. To achieve this purpose, we quantitatively evaluated jaw movements before and after applying J-MAT in TMD patients. Seventeen TMD patients who visited our clinic were selected as subjects. The requirements for participation were: 1) mouth-opening was less than 35 mm, and 2) consent for participation in this study. Jog-manipulation was used on patients, and after a cycle of three MATs several additional cycles were conducted to evaluate the effect of repetitions. Jaw movements were measured by the WinJaw® system at the incisal and condylar points. Measurements were performed at every step of MAT and the results were statistically compared. The average mouth-opening distance before and after treatment was 21.6±6.5 mm and 33.3±6.4 mm, respectively. There was a significant difference between both distances (p<0.01). The average increase in the condylar movement at each step of MAT was as follows. Pivot closing type: 1.8±2.7 mm, Side-to-side type: 1.1±1.1 mm, Opening type: 1.4±1.4 mm, and effect of repetition: 1.0±1.4 mm. The total increase of the condylar movement was 5.3±3.5 mm. ANOVA and Student's t-test were performed before and after treatment and showed a statistical difference (p<0.01). However, the multiple pairwise comparison between each step did not detect any difference, therefore no step was found to be superior over any other. These results showed that the combination of several types of manipulations and several repetitions improved the mouth-opening limitations in TMD patients.