Original scientific paper

Physical therapy with topical ketoprofen and anxiety related to temporomandibular joint pain treatment

Tomislav BADEL ; Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
Ladislav KRAPAC ; Outpatient Center for Rehabilitation Medicine, ˝Rehabilitacija nova˝, Zagreb, Croatia
Ivana SAVIĆ PAVIČIN orcid.org/0000-0002-5210-1765 ; Department of Dental Anthropology, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
Sandra KOCIJAN LOVKO ; Psychiatry Outpatient Department, General Hospital “Zabok”, Zabok, Croatia
Josipa KERN ; Department of Medical Statistics, Epidemiology and Medical Informatics, School of Public Health “Andrija Štampar”, School of Medicine, University of Zagreb, Zagreb, Croatia
Dijana ZADRAVEC ; Department of Diagnostic and Interventional Radiology, Clinical Hospital Center “Sestre milosrdnice”, University of Zagreb, Zagreb, Croatia

Abstract

The aim of this study was to evaluate the level of anxiety and the use of
physical therapy combined with topical application of a non-steroidal antiinflammatory drug ketoprofen gel for the treatment of temporomandibular joint (TMJ) disorder. During an 8-month period, 32 patients were examined (mean age 38.3 years) and went to physical therapy with topically applied Fastum gel. The control group consisted of 20 students of dental medicine (mean age 23.5 years). All subjects were examined by magnetic resonance imaging. The main outcome measuring criteria were: pain intensity rated on a visual-analogue scale, maximal mouth opening capacity, and anxiety evaluated by Spielberger’s State-Trait Anxiety Inventory (STAI 1 – concerning anxiety as subjective state, in a period of last week, including today, and STAI 2 – concerning anxiety as relatively stable individual characteristic). The median of active mouth opening for patients was 40.75 mm before treatment and 52.25 mm for control subjects, which was statistically significant (p < 0.001). The difference in all pain evaluations on AVS scale after the treatment was shown to be statistically significant (t-test with p < 0.001): pain upon mandibular movement was 1.5, 0.1 at rest and 1.7 during palpation. While there were no differences in anxiety levels of STAI 1 (p = 0.0666), there was a statistically significant difference of STAI 2 (p = 0.0096). Comparing asymptomatic subjects, their active mouth opening was greater than in patients before (p < 0.0001) and after the treatment (p < 0.0011). Physical therapy is a recommended modality for TMJ pain treatment. Nevertheless, even immediately after the treatment, the patients had a lower capacity of mouth opening compared to the asymptomatic group.

Keywords

temporomandibular joint; physical medicine; magnetic resonance imaging; treatment; anxiety

Hrčak ID:

116862

URI

https://hrcak.srce.hr/116862

Publication date:

28.2.2014.

Article data in other languages: croatian

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