COMPARATIVE EFFECTIVENESS OF MOBILIZATION AND OCCLUSAL SPLINTS ON PAIN, FUNCTIONAL ABILITY AND QUALITY OF LIFE IN TEMPOROMANDIBULAR DISORDER MANAGEMENT

Abstract

Background: Temporomandibular disorders are common causes of non-dental orofacial pain and may disturb chewing, speaking, jaw mobility, sleep, and oral health-related quality of life. Conservative treatments are usually preferred because they are reversible and safer than invasive approaches. Manual therapy and occlusal splints are frequently used in clinical practice, but their relative effectiveness remains less clearly established, particularly in short-term management of pain and quality-of-life outcomes among patients with temporomandibular disorders.

Objective: To compare the effectiveness of mobilization-based manual therapy and occlusal splint therapy on pain intensity and oral health-related quality of life in patients with temporomandibular disorders.

Methods: This randomized controlled trial was conducted on 24 participants clinically diagnosed with temporomandibular disorders. Participants were randomly allocated into two equal groups. Group A received mobilization-based manual therapy, including temporomandibular joint mobilization, soft tissue techniques, cervical mobilization, and jaw exercises. Group B received individually fabricated occlusal stabilization splints, mainly used at night, over a six-week intervention period. Pain intensity was assessed using the Visual Analog Scale, while oral health-related quality of life was measured using the Oral Health Impact Profile before and after treatment. Data were analyzed using SPSS version 25. The Shapiro–Wilk test assessed normality, while Wilcoxon signed-rank and Mann–Whitney U tests were applied for within-group and between-group comparisons.

Results: The mean age of participants was 38.08 ± 14.01 years, with 14 males and 10 females. In Group A, Visual Analog Scale scores decreased from 6.69 ± 0.85 to 2.07 ± 0.86 (p = 0.001), while Oral Health Impact Profile scores decreased from 35.23 ± 6.57 to 14.84 ± 2.64 (p = 0.001). In Group B, Visual Analog Scale scores decreased from 6.67 ± 0.88 to 3.75 ± 0.75 (p = 0.002), and Oral Health Impact Profile scores decreased from 31.83 ± 2.58 to 20.75 ± 1.86 (p = 0.002). Post-treatment between-group analysis showed significant differences favoring manual therapy for both outcomes (p = 0.001).

Conclusion: Both interventions were effective in managing temporomandibular disorders; however, mobilization-based manual therapy produced greater short-term improvement in pain and oral health-related quality of life.

Keywords: Facial Pain; Musculoskeletal Manipulations; Occlusal Splints; Pain Measurement; Physical Therapy Modalities; Quality of Life; Temporomandibular Joint Disorders.