Assessment of the effects of physiotherapy in patients with bruxism with the use of splint therapy – preliminary study

Background
Bruxism is an increasingly prevalent phenomenon that adversely impacts the masticatory system, often being associated with temporomandibular joint disorders. Dental physiotherapy primarily addresses dysfunctions within the temporomandibular joint, as well as pathology within the cervical section and muscles in the craniofacial region, including the supra and infrahyoid muscles.

Aims
This study aimed to compare the effects of dental physiotherapy between two groups of patients with bruxism, with one group receiving additional treatment using a Michigan relaxation splint.

Material and methods
The study included twenty participants, with one group (n=10) undergoing dental physiotherapy alone (G1), and the second group (n=10) receiving dental physiotherapy along with Michigan relaxation splints (G2). The therapy cycle comprised a total of six visits, occurring twice a week. Therapeutic interventions encompassed fascial work on the face, cervical, sternum, and thorax; deep tissue massage; trigger point development; and post-isometric muscle relaxation. Additionally, patients engaged in the Rocabado exercise program at home.

Results
Therapy resulted in significant improvements in active cervical mobility for both groups across various movements (p<0.05), with no statistically significant differences observed between the two groups after therapy (p>0.05). Also, therapy led to significant improvements in mandibular movements for both groups across various dimensions (p<0.05). There were no statistically significant differences between the two groups after therapy in terms of mandibular abduction, protrusion, and lateral movements (p>0.05). In both groups, a significant reduction in pain was achieved after the therapy (G1 p=0.0051; G2 p=0.0051). In both groups, the number of trigger points and associated pain was significantly reduced after the therapy (p<0.05).

Conclusions
Physiotherapeutic procedures, involving soft tissue work and the incorporation of Rocabado exercises, demonstrated a substantial capacity to enhance the active range of motion (ROM) of the cervical and mandibular regions. Furthermore, these interventions contributed to pain reduction and a decrease in the number of trigger points in patients with bruxism.