Relationship between osteopathic manipulative treatment of the temporomandibular joint, molar shim and the orthostatic position: A randomized, controlled and double blinded study

Abstract

This randomized, controlled, double-blinded study related the effect of osteopathic manipulative treatment (OMT) of the temporomandibular joint (TMJ) and the orthostatic posture using the molar shim (MS) as a postural adjustment factor. Twenty individuals classified with temporomandibular disorder (TMD) were randomly assigned to a treated group (TG, n = 10) and placebo (PG, n = 10). The independent variables were: MS and OMT of the TMJ. The dependent variables were: DC-TMD data; local pressure pain using algometry; and orthostatic posture assessed by the distribution of plantar pressures (baropodometry), in the evaluation periods before and immediately after the interventions. Results: pain did not show a statistically significant difference after the interventions. However, when comparing the Effect Size (ES) between the groups in the post-intervention moment, a moderate relationship was observed for the left trapezius muscle (0.51) and right and left TMJ (0.41 and 0.54 respectively). When correlating the pain and percentage of anteroposterior postural dislocation variables, a significant moderate inverse correlation was observed in the post-intervention moment. The results of the MS pointed to a significant decrease (p ≤ 0.05) of the average peak pressure (Medium P) during the use of the MS (503.4 ± 44.1 kgf/cm2) and after performing the OMT (516.5 ± 49.6 kgf/cm2), both for the TG compared to the pre intervention moment (519.3 ± 42.9 kgf/cm2). There is a correlation between TMJ and orthostatic posture. OMT of the TMJ influences orthostatic posture. The MS can be added to the evaluative context of TMD.

Keywords: Baropodometry; Molar shim; Osteopathic manipulative treatment; Temporomandibular dysfunction; Temporomandibular joint.