Cryotherapy versus Ultrasound on Temporomandibular Joint Dysfunction after Surgical Tooth Extraction. A randomized controlled study

Background: Disorders of the temporomandibular joint (TMJ) due to surgical tooth extraction have a negative impact on jaw function due to pain and locking in the TMJ, causing patients to present with limited mouth opening or difficulty chewing. Purpose: This study compared between the therapeutic effects of cryotherapy and ultrasound on TMJ dysfunction (maximum mouth opening and pain) after surgical tooth extraction. Methods: A randomized controlled trial enrolled 40 patients diagnosed with TMJ dysfunction after surgical tooth extraction, aged 30-60 years. Participants were randomly assigned into two groups (n=20/group): Group A: Cryotherapy in addition to traditional physiotherapy program (deep friction massage, stretching exercises and jaw exercises). Group B: Ultrasound therapy in addition to traditional physiotherapy program, all treatments were applied for one week, three times/week. Maximum mouth opening (MMO) was assessed using Boley Gauge Caliper and pain accompanying TMJ dysfunction was assessed using Visual Analogue Scale (VAS) at baseline, post treatment and follow-up after one week from treatment. Results: There was a significant difference (P<0.05) between the two groups in mean ±SD values of MMO and VAS (P=0.001) at post-treatment and at follow-up. This significant increase in MMO (P=0.0001) and significant decrease in VAS (P=0.005) is favorable in ultrasound therapy group than cryotherapy group. Conclusion: Surgical tooth extraction has a negative effect on TMJ function due to limitation of maximum mouth opening and TMJ pain which are prevalent between those patients. Adding ultrasound therapy to traditional physiotherapy program is crucial for the management of TMJ dysfunction after surgical tooth extraction.