Evaluation of clinical effect of manipulation on masticatory muscle pain guided by MRI

doi:10.3969/j.issn.1674-8115.2023.05.004

Abstract

Abstract:

Objective ·To assess muscle changes of patients of temporomandibular joint disorder with nonstructural disorder by using the Dixon technique for MRI of masticatory muscle, and evaluate the clinical effect of manipulation on masticatory muscle pain guided by MRI. Methods ·A total of 29 patients with TMD masticatory muscle pain (without disc displacement) who were diagnosed for the first time in the Department of Oral Surgery, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine from June 2021 to September 2022 were included. Among them, 9 cases who were assessed with Dixon technique for MRI of masticatory muscle were collected and treated by manipulation. Before treatment, the DICOM Viewer workstation was used to compare the value of masticatory muscle pain area (Z1), the value of ipsilateral non-pain area (Z2) and the value of contralateral corresponding masticatory muscle area (Z3) in Dixon image. Manipulation therapy was performed according to the area of abnormal threshold. Follow-up was performed for 1-4 weeks after treatment, the active maximum mouth opening (MMO) and Visual Analogue Scale (VAS) before and after treatment were compared, and the value of masticatory muscle pain area in Dixon image after treatment was obtained again to evaluate the clinical efficacy. Results ·The mean value of Z2 and Z3 in Dixon was (66.23±32.90) and (66.27±33.87), while Z1 in masticatory muscle pain region was (131.94±83.99), which was significantly higher than Z2 and Z3. Manipulation therapy showed significant improvement in MMO and VAS, and the effective rate was 88.89%. Conclusion ·There is a significant correlation between the imaging findings of Dixon technique for MRI and the pain points of the masticatory muscle reported by the clinical complaints. The manipulation therapy guided by Dixon technique for MRI has a significant effect on improving the degree of mouth opening and pain.

Key words: temporomandibular joint disorder (TMD), masticatory muscle, pain, magnetic resonance imaging, manipulation

CLC Number:

R783.9

YANG Haixia, XU Lili, WANG Bocheng, CHEN Minjie. Evaluation of clinical effect of manipulation on masticatory muscle pain guided by MRI[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(5): 540-544.

Figures/Tables 4

TrendMD

References 22

1	MAÍSA S G, MARCELE J P, CÉLIA M R. Temporomandibular disorders in fibromyalgia syndrome: a short-communication[J]. Revista Brasileira de Reumatologia, 2015, 55(2): 189-194.
2	HARKINS S, LINFORD J, COHEN J, et al. Administration of clonazepam in the treatment of TMD and associated myo-fascial pain: a double-blind pilot study[J]. J Craniomandib Disord, 1991, 5(3): 179-186.
3	VENANCIO R A, ALENCAR F J, ZAMPERINI C. Botulinum toxin, lidocaine, and dry-needling injections in patients with myofascial pain and headaches[J]. Cranio, 2009, 27(1): 46-53.
4	AL-ANI Z, GRAY R J, DAVIES S J, et al. Stabilization splint therapy for the treatment of temporomandibular myofascial pain: a systematic review[J]. J Dent Educ, 2005, 69(11): 1242-1250.
5	VENEZIAN G C, DA S M, MAZZETTO R G, et al. Low level laser effects on pain to palpation and electromyographic activity in TMD patients: a double-blind, randomized, placebo-controlled study[J]. Cranio, 2010, 28(2): 84-91.
6	DE L A, STAPPAERTS K, PAPY S. Consueling and physical therapy as treatment for myofascial pain of the masticatory system[J]. J Orofac Pain, 2003, 17(1): 42-49.
7	LEE Y H, LEE K M,AUH Q S, et al. Magnetic resonance imaging-based prediction of the relationship between whiplash injury and temporomandibular disorders[J]. Front Neurol, 2017, 8, 725.
8	MS S, WALDMAN H, KRINGS B, et al. Effect of curcumin supplementation on exercise-induced oxidative stress, inflammation, muscle damage, and muscle soreness[J]. J Diet Suppl, 2020; 17(4): 401-414.
9	VAN D J, PENNATI F, HANSEN H H, et al. Respiratory muscle imaging by ultrasound and MRI in neuromuscular disorders[J]. Eur Respir J, 2021, 58(5): 2100137.
10	MARTEL-DUGUECH L, ALONSO-PÉREZ J, BASCUÑANA H, et al. Intramuscular fatty infiltration and physical function in controlled acromegaly[J]. Eur J Endocrinol, 2021, 185(1): 167-177.
11	CHANDOLA H C, CHAKRABORTY A. Fibromyalgia and myofascial pain syndrome:a dillema[J]. Indian J Anaesth, 2009, 53(5): 575-581.
12	DELGADO E V, ROMERO J C, ESCODA C G. Myofascial pain syndrome associated with trigger points: a literature review. (I): Epidemiology, clinical treatment and etiopathogeny[J]. Med Oral Pathol Oral Cir Bucal, 2009, 14(10):e494-e498.
13	VELLY A M, GORNITSKY M, PHILIPPE P. Contributing factors to chronic myofascial pain: a case-control study[J]. Pain, 2003, 104(3): 491-499.
14	ARIJI Y, SAKUMA S, IZUMI M, et al. Ultrasonographic features of the masseter muscle in female patients with temporomandibular disorder associated with myofascial pain[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2004, 98: 334-41.
15	BAKKE M, THOMSEN C E, VILMANN A, et al. Ultrasonographic assessment of the swelling of the human masseter muscle after static and dynamic activity[J]. Arch Oral Biol, 1996, 41: 133-40.
16	YUTAKA N, HIDEYOSHI N, TAKAHUMI H I. The relationship between masseter muscle pain and T2 values in temporomandibular joint disorders[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2018,126(4): 349-354.
17	DIXON W T. Simple proton spectroscopic imaging[J]. Radiology,1984, 153: 189-194.
18	MEDLICOTT M S, HARRIS S R. A systematic review of the effectiveness of exercise, manual therapy, electrotherapy, relaxation training, and biofeedback in the management of temporomandibular disorder[J]. Phys Ther, 2006, 86: 955-973.
19	SESSLE B J. Neural mechanisms and pathways in craniofacial pain[J]. Can J NeurolSci, 1999, 26(suppl 3): S7-S11.
20	GERI T, VICECONTI A, MINACCI M, et al. Manual therapy: exploiting the role of human touch. Musculoskelet Sci Pract[J]. 2019, 44: 102044.
21	GYER G, MICHAEL J, INKLEBARGER J, et al. Spinal manipulation therapy: is it all about the brain? A current review of the neurophysiological effects of manipulation[J]. J Integr Med, 2019, 17(5): 328-337.
22	URBAŃSKI P, TRYBULEC B, PIHUT M. The Application of Manual Techniques in Masticatory Muscles Relaxation as Adjunctive Therapy in the Treatment of Temporomandibular Joint Disorders[J]. Int J Environ Res Public Health, 2021, 18(24): 12970.

Case No.	Tender area of masticatory muscle	Z
Case No.	Tender area of masticatory muscle	Z1	Z2	Z3
1	Left coronoid process	124.00	82.70	83.16
2	Right coronoid process	323.39	112.79	115.87
3	Left maxillary tuberosity	80.63	34.08	34.62
4	Right superior segment of masseter	213.55	108.51	107.27
5	Left middle segment of masseter	77.07	52.85	52.85
6	Right inferior segment of masseter	154.34	87.40	87.45
7	Right temporal region	115.10	72.45	74.36
8	Left inferior segment of masseter	41.26	25.55	24.49
9	Right superior segment of masseter	58.07	19.73	16.72
Mean value		131.94±83.99	66.23±32.90	66.27±33.87

Case No.	Tender area of masticatory muscle	Z
Case No.	Tender area of masticatory muscle	Z1	Z2	Z3
1	Left coronoid process	124.00	82.70	83.16
2	Right coronoid process	323.39	112.79	115.87
3	Left maxillary tuberosity	80.63	34.08	34.62
4	Right superior segment of masseter	213.55	108.51	107.27
5	Left middle segment of masseter	77.07	52.85	52.85
6	Right inferior segment of masseter	154.34	87.40	87.45
7	Right temporal region	115.10	72.45	74.36
8	Left inferior segment of masseter	41.26	25.55	24.49
9	Right superior segment of masseter	58.07	19.73	16.72
Mean value		131.94±83.99	66.23±32.90	66.27±33.87

Case No.	MMO/mm		VAS/score		Efficacy evaluation
Case No.	Before	After	Before	After	Efficacy evaluation
1	21	38	6	2	good
2	15	30	7	4	good
3	26	35	7	4	good
4	19	38	6	2	good
5	24	35	5	1	good
6	31	39	4	2	good
7	36	40	3	2	poor
8	25	35	5	2	good
9	24	37	0	0	excellent
Mean value	24.56±5.87	36.33±2.83	4.78±2.10	2.11±1.20

Case No.	MMO/mm		VAS/score		Efficacy evaluation
Case No.	Before	After	Before	After	Efficacy evaluation
1	21	38	6	2	good
2	15	30	7	4	good
3	26	35	7	4	good
4	19	38	6	2	good
5	24	35	5	1	good
6	31	39	4	2	good
7	36	40	3	2	poor
8	25	35	5	2	good
9	24	37	0	0	excellent
Mean value	24.56±5.87	36.33±2.83	4.78±2.10	2.11±1.20

[1]	ZHANG Chen, GUO Qihui, FAN Qing. Research progress in brain morphological characteristics of obsessive-compulsive disorder [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(4): 480-486.
[2]	LIU Chenjun, YIN Bohao, SUN Hui, ZHANG Wei. Application of non-invasive methods of radiology to the osteoporosis [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(3): 385-390.
[3]	WU Bing, LI Xiaomin, LIU Siyu, ZHAO Lulu, WU Wen, HAO Yongqiang, AI Songtao. Preliminary application of improved 3D printed pathological section box to assisting stitching pathological images of bone tumor [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(2): 180-187.
[4]	LIU Siyu, WU Bing, LI Xiaomin, ZHAO Lulu, CHEN Jun, AI Songtao. Preliminary exploration of diffusion-weighted imaging in pre-surgical planning of dermatofibrosarcoma protuberans [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022, 42(8): 1095-1102.
[5]	ZHANG Huanyu, JIANG Yiting, ZHU Xiaochen, HE Zhiyan, ZHOU Wei, SONG Zhongchen. Effects of gingipain extracts on brain neuroinflammation in mice [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022, 42(5): 570-577.
[6]	CHEN Liqi, XUE Zhuowei, WU Qingkai. Review of MRI-based three-dimensional digital model reconstruction of female pelvic floor organs [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022, 42(3): 381-386.
[7]	Xuehong WANG, Xuzhuo CHEN, Yi MAO, Da SHEN, Shanyong ZHANG. Difference in recurrence rates after temporomandibular joint disc repositioning surgery with miniscrew anchor at different developmental stages in adolescents [J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2022, 42(2): 173-177.
[8]	Yihuan WANG, Ruokun LI, Huanhuan CHONG, Fuhua YAN. Research progress of Gd-EOB-DTPA-enhanced magnetic resonance imaging in the evaluation of biological behavior of hepatocellular carcinoma [J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2022, 42(1): 130-134.
[9]	Cui CHEN, Ye JIN, Lin WANG, Hongli LI, Caifeng WAN, Lixin JIANG. Comparative analysis of 30 cases of metaplastic carcinoma of the breast [J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2022, 42(1): 70-76.
[10]	Zi-han WANG, Jie SHEN, Yan LUO. Analgesic effect of multiple spinal nerve block on video-assisted thoracoscopic segmentectomy or lobectomy [J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(8): 1062-1067.
[11]	Zi-hao LIU, Wen-fang TANG, Hui WANG. Research progress in amino acid PET imaging of pediatric brain tumors [J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(7): 949-952.
[12]	Xin JIANG, Ying HE, Bin CAI, Shuai FAN, Xiao-yan LI, Zhi-bin KANG. Procedural manipulation under anesthesia for joint adhesion after trauma of knee operation: report of 21 cases [J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(4): 479-482.
[13]	Feng-qiao WANG, Lei ZHUANG, Fu-jun ZHANG. Research progress of children's pain memories [J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(4): 546-549.
[14]	Qun-feng WANG, Li CAO, Xing-hua LUAN. Review of clinical application of peripheral neuropathy scales [J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(11): 1518-1523.
[15]	JI Ying-ying, XUE Bin, HUANG Yue, ZHANG Jian-wei. Efficacy and safety of oral midazolam in combination with intranasal dexmedetomidine for paediatric magnetic resonance imaging sedation [J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2020, 40(8): 1098-1102.