Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Rehabilitation Medicine, Sijing Hospital of the Songjiang District of Shanghai, Shanghai, China.
J Oral Rehabil. 2024 Dec;51(12):2611-2621. doi: 10.1111/joor.13865. Epub 2024 Sep 20.
Physical therapy is the preferred conservative treatment for patients with temporomandibular disorder (TMD). However, few studies have investigated the application of physical therapy in adolescents, especially follow-up studies on the long-term prognosis of these patients. This study investigated the short-term effects and long-term prognosis of physical therapy in adolescent patients with TMD and the factors influencing long-term symptoms.
Information regarding baseline data, specific treatment methods, treatment times and evaluation results was collected retrospectively for adolescent patients with TMD who received physical therapy. Patients were followed up via telephone and online questionnaires, and the influence of age, sex, disease course, mouth opening, pain intensity, oral parafunctional habits and treatment methods on long-term symptoms was analysed.
Pain intensity, maximum mouth opening and the joint noise score improved significantly in 270/286 patients who received individualised comprehensive physical therapy. TMD-related symptoms improved with no noticeable impact on daily life in 187/199 patients who were followed up for an extended period (average, 30.71 ± 10.86 months) and were divided into asymptomatic or symptomatic groups according to the persistence of symptoms. Logistic regression analysis revealed that uncorrected oral parafunctional habits and fewer treatments were related to long-term symptoms.
The long-term prognosis of adolescent patients with TMD after physical therapy was satisfactory. However, 52.8% of the patients experienced persistent TMD-related symptoms for an extended period, possibly due to insufficient treatment times and parafunctional habits.
ClinicalTrials.gov identifier: NCT05781607.
物理疗法是治疗颞下颌关节紊乱（TMD）患者的首选保守治疗方法。然而，很少有研究调查物理疗法在青少年中的应用，尤其是这些患者的长期预后的随访研究。本研究调查了物理疗法治疗青少年 TMD 患者的短期效果和长期预后，以及影响长期症状的因素。
回顾性收集接受物理疗法的青少年 TMD 患者的基线数据、具体治疗方法、治疗次数和评估结果等信息。通过电话和在线问卷调查对患者进行随访，分析年龄、性别、病程、张口度、疼痛强度、口腔功能紊乱习惯和治疗方法对长期症状的影响。
270/286 例接受个体化综合物理治疗的患者疼痛强度、最大张口度和关节弹响评分均显著改善。187/199 例长期随访（平均 30.71±10.86 个月）患者的 TMD 相关症状改善，日常生活无明显影响，根据症状持续情况分为无症状或有症状组。Logistic 回归分析显示，未经矫正的口腔功能紊乱习惯和治疗次数较少与长期症状相关。
青少年 TMD 患者经物理治疗后的长期预后令人满意。然而，52.8%的患者长期持续存在 TMD 相关症状，可能与治疗次数不足和功能紊乱习惯有关。
ClinicalTrials.gov 标识符：NCT05781607。
