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Osteopathic treatment approaches for craniomandibular dysfunctions


Author: Ali Aydin
Supervisor: Dr. Sabine Willeke-Kerkhoff

Introduction: The aim of the study was to evaluate osteopathic versus sham treatment in CMD-patients regarding pain and mobility of the mandible. 

Study design and Methods: Performed was a randomized controlled trial with a follow-up of two months. 14 dentists confirmed the diagnosis CMD and assigned the patients to the osteopathic praxis where the study was performed from12/2011 to 4/2012. 40 patients were included (36 women, 4 men; aged between 24 and 60 years). After randomization 25 patients were assigned to the treatment group and 15 patients to the control group. Patients of the intervention group received three times osteopathic treatments and in the control group three times sham treatments (ultra-sound without power) were carried out within intervals of each seven days. The main outcome parameter “pain intensity” was measured via the numerical rating scale (NRS). Secondary parameters were vertical and horizontal movements of the mandibula as well as deviation.

Results: The osteopathic treatment resulted in a statistic significant improvement of all the proofed parameters up to seven days after the third intervention.  In the treatment group mean average pain intensity decreased from 5.48 ± 0.66 to 0.68 ± 0,35 cm (- 4,8; 95% C.I. 2,1 – 1,3; p < 0,001). The other endpoints of the study (vertical and horizontal movements of the mandibula, deviation) were significantly improved also up to seven days after the third osteopathic treatment. In contrast to these findings, within the control group all the outcome parameters remained statistically unchanged during the study. Investigations two months after the third osteopathic treatment demonstrated that the improvements of the typical CMD – symptoms remained unchanged.

Conclusion: Three osteopathic treatments in a three-week period resulted in a significant improvement of CMD-specific pain intensity and disturbances of the mandibula movements for at least 2 months.

Keywords: Osteopathic therapy – Craniomandibular dysfunction – Pain measurement – Oral opening – Deviation