Evaluation of clinical effect of manipulation on masticatory muscle pain guided by MRI
YANG Haixia,1, XU Lili1, WANG Bocheng2, CHEN Minjie,3
1.Department of Physical Medicine & Rehabilitation, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
2.Department of Radiology, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
3.Department of Oral Surgery, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
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.
YANG Haixia, XU Lili, WANG Bocheng, CHEN Minjie. Evaluation of clinical effect of manipulation on masticatory muscle pain guided by MRI. Journal of Shanghai Jiao Tong University (Medical Science)[J], 2023, 43(5): 540-544 doi:10.3969/j.issn.1674-8115.2023.05.004
The study was designed by YANG Haixia and CHEN Minjie; The manuscript was drafted and revised by YANG Haixia; Image data was analyzed by WANG Bocheng; Clinical data was analyzed by XU Lili. All the authors have read the last version of paper and consented for submission.
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COMPETING INTERESTS
All authors disclose no relevant conflict of interests.
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