Multimodal Physiotherapeutic Treatment in Adolescents With Temporomandibular Disorders: A Randomised Controlled Trial

Adolescence is a period of transition and vulnerability during which physiological development occurs, and may be impaired in the presence of temporomandibular disorders (TMDs), an undertreated condition that lacks debate about effective treatment modalities.

To verify the effect of a multimodal physiotherapeutic treatment in an in-person group and telerehabilitation formats on outcomes, including peripheral muscle oxygenation, perceived pain intensity, pressure pain threshold (PPT), range of motion (ROM), and mandibular function in adolescents with TMDs.

This randomised controlled trial included 26 adolescents with TMDs, assigned to a telerehabilitation (GT) or in-person treatment (GP) group. Participants underwent baseline assessment, three 30-min weekly treatments, immediate reassessment and follow-up after 30 days. The study used Diagnostic Criteria for Temporomandibular Disorders, near-infrared spectroscopy, the Numerical Rating Scale (NRS) and an algometer. The physical therapy protocol included counselling, manual therapy, and exercises.

The GP group showed a statistically significant difference in tissue saturation index of the masseter muscle at rest, and an important clinical improvement in the PPT of the masseter and temporal muscles, although the difference was not statistically significant. In both groups, an intra-group analysis showed a significant improvement in the NRS, ROM and mandibular function at all time points.

In-person treatment was superior for peripheral oxygenation of the masseter muscle at rest and for PPT. However, both the GP and GT groups demonstrated improvements in NRS, ROM and mandibular function in adolescents with TMDs.