The Effect of PIR and MRT on Muscle Stiffness and Pain in Individuals With Bruxism

Not Applicable

• Conditions: Myofascial Release Technique; Bruxism; Post-isometric Relaxation Technique
• Interventions: Other: Myofascial Release Technique; Other: Post-isometric Relaxation Technique; Other: Control

• Registration Number: NCT06450782
• Lead Sponsor: Istinye University

Brief Summary

Bruxism is a repetitive jaw muscle activity that occurs during sleep or while awake, characterized by teeth clenching or grinding. Bruxism affects millions of people worldwide and is considered one of the most harmful activities for the stomatognathic system due to its morphological, pathophysiological, psychosocial features and clinical consequences. Repetitive teeth clenching and grinding movements can cause spasms, stiffness, pain, and activity changes in the chewing muscles. Since bruxism is a disorder that depends on many variables, there is no single, specific treatment and multidisciplinary approaches are often required. Most treatment strategies are conservative and symptomatic, aiming to prevent the consequences of the disorder. The main purpose of physiotherapy techniques is to reduce the negative effects of bruxism on the chewing system. Physiotherapy techniques include exercises, manual therapy, electrotherapy, acupuncture, and posture awareness. It is not clear in the literature which physiotherapy techniques are effective in the management of bruxism; Therefore, more controlled studies need to be conducted. When studies in the literature are examined, no studies have been found that objectively investigate the effectiveness of relaxation techniques alone in people with muscle pain and increased muscle stiffness due to teeth clenching problems. Within the scope of this project, it is planned to investigate the effectiveness of the myofascial release technique (MRT) and post-isometric relaxation technique (PİRT) using the grastone tool.

Detailed Description

Bruxism is a repetitive jaw muscle activity that occurs during sleep or while awake, characterized by teeth clenching or grinding. Bruxism affects millions of people worldwide and is considered one of the most harmful activities for the stomatognathic system due to its morphological, pathophysiological, psychosocial features and clinical consequences. Repetitive teeth clenching and grinding movements can cause spasms, stiffness, pain, and activity changes in the chewing muscles. Since bruxism is a disorder that depends on many variables, there is no single, specific treatment and multidisciplinary approaches are often required. Most treatment strategies are conservative and symptomatic, aiming to prevent the consequences of the disorder. The main purpose of physiotherapy techniques is to reduce the negative effects of bruxism on the chewing system. Physiotherapy techniques include exercises, manual therapy, electrotherapy, acupuncture, and posture awareness. It is not clear in the literature which physiotherapy techniques are effective in the management of bruxism; Therefore, more controlled studies need to be conducted. When studies in the literature are examined, no studies have been found that objectively investigate the effectiveness of relaxation techniques alone in people with muscle pain and increased muscle stiffness due to teeth clenching problems. Within the scope of this project, it is planned to investigate the effectiveness of the myofascial release technique (MGT) and post-isometric relaxation technique (PGT) using the grastone tool. MGT provides pain relief and functional recovery by creating a low load and long-term stretching effect on the myofascial structure. Post-isometric relaxation technique (PGT), a muscle energy technique, involves voluntary contraction in a precisely controlled direction against resistance. The results of this study will reveal the effects of MGT and PGT, which have different mechanisms of action, on muscle stiffness and pain in people with bruxism. In addition, by analyzing and presenting the data obtained, the gap in the current literature will be filled and it will contribute to becoming a component of the frequently used physiotherapy program in the management of bruxism. It is expected that patients' quality of life and productivity will increase depending on the relief of their symptoms. The study is a prospective, randomized, controlled, double-blind study. People with bruxism will be informed about the study and an informed consent form will be obtained. Participants' age, gender, body weight, height and Body Mass Index (BMI) will be evaluated and recorded with a specially prepared evaluation form. Individuals with bruxism between the ages of 18-65 who volunteer to participate in the study will be included. The study included patients with neurological, psychiatric, or systemic disease, dental treatment or physical therapy, using occlusal splints, being pregnant and having active cancer, having surgery planned for the relevant areas, having no more than two molars, using removable prostheses, and those using temporomandibular joint in the last three months. People receiving treatment will be excluded. Participants will be randomly divided into three groups. Participants will be assigned to the MGT group, PGT group, and Control group. In our study, MyotonPRO will be used to evaluate the stiffness of the sternocleidomastoid and masseter muscles of bruxism patients and the visual analog scale will be used to evaluate pain. All evaluations will be made by the same researcher before and immediately after the single-session intervention. No intervention will be made to the chin and cervical area before the first measurement. There will be a 2-minute break before the second evaluation begins.

Basic Information
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Recruitment & Eligibility
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Study & Design
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Trial Locations

Study Timeline

• Status Verified: 2024-06
• Study First Submitted: 2024-06-05
• Study First Submitted QC: 2024-06-05
• Last Update Submitted: 2024-06-05
• Study First Posted: 2024-06-10
• Last Update Posted: 2024-06-10
• Study Start: 2024-06-15
• Primary Completion: 2024-08-15
• Study Completion: 2024-10-15

Recruitment & Eligibility

• Status: ENROLLING_BY_INVITATION
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

Being diagnosed with bruxism Being willing and volunteer to work

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Exclusion Criteria

Having a neurological, psychiatric or systemic disease Being addicted to alcohol and drugs Getting dental treatment or physical therapy Using an occlusal splint being pregnant actively having cancer Planning surgery for relevant areas Not having more than two molars Using removable dentures Receiving treatment for the temporomandibular joint in the last three months

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
PIR Group	Control	Participants in the PIR Group will apply one session of post-isometric relaxation technique.
MR Grup	Myofascial Release Technique	Participants in the MR Group will apply one session of myofascial release technique.
PIR Group	Post-isometric Relaxation Technique	Participants in the PIR Group will apply one session of post-isometric relaxation technique.

Primary Outcome Measures

Name	Time	Method
Muscle Stiffness	1 Day	MyotonPRO (Muomeetria Ltd., Tallinn, Estonia) will be used to measure the stiffness of the muscles. This device works by producing a mechanical impulse on the skin over the muscle being measured. Mechanical oscillations of muscles created by mechanical impulses are measured by MyotonPRO. Muscle stiffness is measured in Newtons per meter (N/m). This method can determine the muscle's resistance to deforming forces or muscle stiffness.; In the study, measurements will be made at room temperature at approximately 25°C, and after the participants sit on a chair for 5 minutes. During the measurement, participants will be asked to contact the SCM and masseter muscles with maximum force, and the most prominent location of the muscles will be marked. The stiffness of both muscles will be measured in both relaxed and maximum contraction conditions. All measurements will be taken 3 times and their averages will be calculated.
Pain Intensity	1 Day	For pain intensity according to VAS, "no pain" is usually rated as 0 points and "worst pain imaginable" as 10 points (10 cm scale). Ranges for pain intensity; \<3 is mild pain, 3-6 is moderate pain, \>6 is severe pain.

Secondary Outcome Measures

Name	Time	Method
Range Of Montion	1 Day	A caliper will be used for maximum mouth opening and a linear ruler will be used for slides. For maximal mouth opening, the patient will be asked to open his mouth as much as he can, the movement is repeated three times, and when the mouth is opened for the third time, the distance between the lower and upper incisors will be measured and recorded.

Trial Locations

Locations (1)

Yunus Emre TÜTÜNEKEN; 🇹🇷 Istanbul, Zeytinburnu, Turkey