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The Association Between Temporomandibular Disorders and Sacroiliac Joint Dysfunction

Primary Purpose

Temporomandibular Joint Disorders, Temporomandibular Disorder

Status
Recruiting
Phase
Not Applicable
Locations
Turkey
Study Type
Interventional
Intervention
Orofacial Manual Therapy
Sponsored by
Marmara University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Temporomandibular Joint Disorders focused on measuring Temporomandibular Joint Disorders, Temporomandibular Joint, Sacroiliac Joint, Orofacial Pain

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Volunteered to participate, Aged between 18-60 years old, Having the diagnosis of Temporomandibular Disorders (TMB) and sacroiliac joint disfunction (SIJD), Exclusion Criteria: Having a malignant condition, trauma and surgery of the cranial and cervical region, Not being cooperative, Regular use of analgesic and anti-inflammatory drugs, Having dentofacial anomalies, Having active inflammatory arthritis, Having metabolic diseases (Gout, osteoporosis, Cushing's disease and hyper/hypo-parathyroidism), Having connective tissue, rheumatological (Systemic lupus erythematosus and scleroderma) and hematological disorders (Anemia and leukemia), Having a diagnosed psychiatric illness, Receiving TMD-related physical therapy less than 6 months ago

Sites / Locations

  • Sultan İğrekRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment Group

Arm Description

Participants in this group will be received orofacial manual therapy as treatment. The number of participants is planned to be 23.

Outcomes

Primary Outcome Measures

Pain Threshold: Digital algometer
The algometer is a reliable instrument for measuring the sensitivity of the masticatory muscles and 1 cm below the Posterior Superior Iliac Spine (PSIS). The measurement will be made at 10 points. A force (Newton in force) of 1 kg (weight in kilogram) per square centimeter (surface area in centimeter square) is applied to the patient for 3 seconds, and this is continued until the patient feels pain (weight and surface area will be combined to report Newton in kg/ cm2). This process will be repeated three times and the average value will be calculated.
Range of Motion
Mouth opening, protrusion and right and left lateral deviation will be measured starting from 0 using a 15 cm ruler. Repeated measuring reduces the standard error of measurement, hence repeated measurements will be also included in our study (three times) with the largest recorded range taken.
First Test for Sacroiliac Joint Disfunction: Distraction Test
The patient lies in a supine position. Direct posterolateral pressure is applied to the bilateral anterior superior iliac spines, thus stressing the anterior sacroiliac ligament. Pathology in the Sacroiliac (SI) joint is considered if pain occurs in the hip.
Second Test for Sacroiliac Joint Disfunction: Compression Test
The patient lies on his side with the affected side on top, with the hip at 45° flexion and the knees at 90° flexion. The physician stands behind the patient and applies pressure to the pelvis over the iliac crest directly toward the contralateral iliac crest. This test can be applied in a supine or prone position. Pathology in the SI joint is considered if pain occurs in the hip.
Third Test for Sacroiliac Joint Disfunction: Thigh Thrust Test
The patient lies in a supine position. The hip is brought to 90º flexion. Pressure is applied directly toward the examination table. Pathology in the SI joint is considered if pain occurs in the hip. Pain provocation is established with hip flexion and adduction.
Fourth Test for Sacroiliac Joint Disfunction: Gaenslen Test
The patient lies in a supine position close to the edge of the bed. The patient draws his leg toward the abdomen so as to place the knee and hip in flexion. The outside leg (closest to the practitioner) is allowed to hang down from the examination table, while the SI joint is contracted by placing pressure on the inside (furthest from the practitioner) iliac crest and outside leg. Pain indicates pathology of the SI joint on the tested side.
Fifth Test for Sacroiliac Joint Disfunction: Sacral Thrust Test
The patient lies in a prone position. The practitioner places one hand on the apex of the sacrum while applying direct pressure with the other hand. Pathology in the SI joint is considered if pain occurs in the hip.
Sixth Test for Sacroiliac Joint Disfunction: Faber (Patrick) Test
The patient lies in a supine position, while the practitioner stands beside the patient and bends the patient's knee, bringing the heel to the opposite knee. With the other hand, the practitioner ensures that the contralateral anterior superior iliac spine remains in a neutral position. The physician applies mild pressure to the bent knee. Pressure is assumed to be applied to the bilateral SI ligaments and hip joints. Pathology in the SI joint is considered if pain occurs in the hip. Pain provocation occurs with flexion, adduction and external rotation of the hip.

Secondary Outcome Measures

Oswestry Disability Index (ODI) for Functional Low Back Pain
Oswestry Disability Index (ODI) will be used to evaluate low back pain. ODI consists of 10 items on the degree of severity to which low back trouble has affected the ability to manage in everyday life. The 10 sections cover the pain and the daily function (including pain intensity, personal hygiene, lifting, walking, sitting, standing, sleeping, sexual activity, social activity, and traveling). Each item is rated on a 6-point scale (0-5); the higher score means the higher level of disability related to low back pain.

Full Information

First Posted
August 25, 2023
Last Updated
September 6, 2023
Sponsor
Marmara University
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1. Study Identification

Unique Protocol Identification Number
NCT06035341
Brief Title
The Association Between Temporomandibular Disorders and Sacroiliac Joint Dysfunction
Official Title
Is There a Association Between Temporomandibular Disorders and Sacroiliac Joint Dysfunction?
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
September 1, 2023 (Actual)
Primary Completion Date
September 15, 2023 (Anticipated)
Study Completion Date
October 15, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Marmara University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The aim of this study is to evaluate the relationship between Temporomandibular Disorders (TMD) and Sacroiliac Joint Disfunction (SIJD) and to determine the immediate effect of single-session orofacial manual therapy on SIJD. Patients will be treated for 1 session. The evaluation was planned to be done twice, at the beginning and end of the session.
Detailed Description
The aim of this study is to evaluate the relationship between TMD and SIJD and to determine the immediate effect of single-session orofacial manual therapy on SIJD. Patients diagnosed with both TMD and SIJD will be participants of the study. Patients will be treated for 1 session. Immediately after the treatment, participants will be asked to walk for 5 minutes, after which a second assessment will be done. The evaluation was planned to be done twice, at the beginning and end of the session. Pressure pain threshold, joint range of motion, functionality, and sacroiliac joint disfunction will be evaluated by using digital algometer, ruler, "Oswestry Disability Index (ODI)" and specific tests respectively.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Temporomandibular Joint Disorders, Temporomandibular Disorder
Keywords
Temporomandibular Joint Disorders, Temporomandibular Joint, Sacroiliac Joint, Orofacial Pain

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
There are one study group. A single session of orofacial manual therapy will be applied to all participants.
Masking
None (Open Label)
Allocation
N/A
Enrollment
23 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Treatment Group
Arm Type
Experimental
Arm Description
Participants in this group will be received orofacial manual therapy as treatment. The number of participants is planned to be 23.
Intervention Type
Other
Intervention Name(s)
Orofacial Manual Therapy
Intervention Description
As orofacial manual therapy, soft tissue (intraoral and extraoral trigger point therapy and myofascial release of painful muscles) and joint mobilization (caudal and ventro-caudal traction, ventral and mediolateral translation), muscle energy technique, fascia mandibularis release, occipital release and ligamentous treatment was planned.
Primary Outcome Measure Information:
Title
Pain Threshold: Digital algometer
Description
The algometer is a reliable instrument for measuring the sensitivity of the masticatory muscles and 1 cm below the Posterior Superior Iliac Spine (PSIS). The measurement will be made at 10 points. A force (Newton in force) of 1 kg (weight in kilogram) per square centimeter (surface area in centimeter square) is applied to the patient for 3 seconds, and this is continued until the patient feels pain (weight and surface area will be combined to report Newton in kg/ cm2). This process will be repeated three times and the average value will be calculated.
Time Frame
Change between baseline (immediately before intervention) and post intervention (immediately after intervention). The intervention is one hour.
Title
Range of Motion
Description
Mouth opening, protrusion and right and left lateral deviation will be measured starting from 0 using a 15 cm ruler. Repeated measuring reduces the standard error of measurement, hence repeated measurements will be also included in our study (three times) with the largest recorded range taken.
Time Frame
Change between baseline (immediately before intervention) and post intervention (immediately after intervention). The intervention is one hour.
Title
First Test for Sacroiliac Joint Disfunction: Distraction Test
Description
The patient lies in a supine position. Direct posterolateral pressure is applied to the bilateral anterior superior iliac spines, thus stressing the anterior sacroiliac ligament. Pathology in the Sacroiliac (SI) joint is considered if pain occurs in the hip.
Time Frame
Change between baseline (immediately before intervention) and post intervention (immediately after intervention). The intervention is one hour.
Title
Second Test for Sacroiliac Joint Disfunction: Compression Test
Description
The patient lies on his side with the affected side on top, with the hip at 45° flexion and the knees at 90° flexion. The physician stands behind the patient and applies pressure to the pelvis over the iliac crest directly toward the contralateral iliac crest. This test can be applied in a supine or prone position. Pathology in the SI joint is considered if pain occurs in the hip.
Time Frame
Change between baseline (immediately before intervention) and post intervention (immediately after intervention). The intervention is one hour.
Title
Third Test for Sacroiliac Joint Disfunction: Thigh Thrust Test
Description
The patient lies in a supine position. The hip is brought to 90º flexion. Pressure is applied directly toward the examination table. Pathology in the SI joint is considered if pain occurs in the hip. Pain provocation is established with hip flexion and adduction.
Time Frame
Change between baseline (immediately before intervention) and post intervention (immediately after intervention). The intervention is one hour.
Title
Fourth Test for Sacroiliac Joint Disfunction: Gaenslen Test
Description
The patient lies in a supine position close to the edge of the bed. The patient draws his leg toward the abdomen so as to place the knee and hip in flexion. The outside leg (closest to the practitioner) is allowed to hang down from the examination table, while the SI joint is contracted by placing pressure on the inside (furthest from the practitioner) iliac crest and outside leg. Pain indicates pathology of the SI joint on the tested side.
Time Frame
Change between baseline (immediately before intervention) and post intervention (immediately after intervention). The intervention is one hour.
Title
Fifth Test for Sacroiliac Joint Disfunction: Sacral Thrust Test
Description
The patient lies in a prone position. The practitioner places one hand on the apex of the sacrum while applying direct pressure with the other hand. Pathology in the SI joint is considered if pain occurs in the hip.
Time Frame
Change between baseline (immediately before intervention) and post intervention (immediately after intervention). The intervention is one hour.
Title
Sixth Test for Sacroiliac Joint Disfunction: Faber (Patrick) Test
Description
The patient lies in a supine position, while the practitioner stands beside the patient and bends the patient's knee, bringing the heel to the opposite knee. With the other hand, the practitioner ensures that the contralateral anterior superior iliac spine remains in a neutral position. The physician applies mild pressure to the bent knee. Pressure is assumed to be applied to the bilateral SI ligaments and hip joints. Pathology in the SI joint is considered if pain occurs in the hip. Pain provocation occurs with flexion, adduction and external rotation of the hip.
Time Frame
Change between baseline (immediately before intervention) and post intervention (immediately after intervention). The intervention is one hour.
Secondary Outcome Measure Information:
Title
Oswestry Disability Index (ODI) for Functional Low Back Pain
Description
Oswestry Disability Index (ODI) will be used to evaluate low back pain. ODI consists of 10 items on the degree of severity to which low back trouble has affected the ability to manage in everyday life. The 10 sections cover the pain and the daily function (including pain intensity, personal hygiene, lifting, walking, sitting, standing, sleeping, sexual activity, social activity, and traveling). Each item is rated on a 6-point scale (0-5); the higher score means the higher level of disability related to low back pain.
Time Frame
Change between baseline (immediately before intervention) and 1 week post intervention. The intervention is one hour.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Volunteered to participate, Aged between 18-60 years old, Having the diagnosis of Temporomandibular Disorders (TMB) and sacroiliac joint disfunction (SIJD), Exclusion Criteria: Having a malignant condition, trauma and surgery of the cranial and cervical region, Not being cooperative, Regular use of analgesic and anti-inflammatory drugs, Having dentofacial anomalies, Having active inflammatory arthritis, Having metabolic diseases (Gout, osteoporosis, Cushing's disease and hyper/hypo-parathyroidism), Having connective tissue, rheumatological (Systemic lupus erythematosus and scleroderma) and hematological disorders (Anemia and leukemia), Having a diagnosed psychiatric illness, Receiving TMD-related physical therapy less than 6 months ago
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Sultan Igrek, MSc
Phone
+05372100654
Email
sultanigrek@gmail.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tugba Kuru Colak, Asst. Prof
Organizational Affiliation
Marmara University Institute of Health Sciences
Official's Role
Study Director
Facility Information:
Facility Name
Sultan İğrek
City
Istanbul
ZIP/Postal Code
34275
Country
Turkey
Individual Site Status
Recruiting
Facility Contact:
Phone
05372100654

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Study Protocol, Statistical Analysis Plan (SAP), Informed Consent Form (ICF), Clinical Study Report (CSR) might be considered to be shared with clinicians studying in the same field one year after the publication of the study.
Citations:
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Links:
URL
https://jag.journalagent.com/kocaelitip/pdfs/KTD_10_2_27_32.pdf
Description
Investigation of the Relationship Between Temporomandibular Disorder and Postural Analysis
URL
https://www.semanticscholar.org/paper/Manual-therapy-for-temporomandibular-disorders%3A-A-Kalamir-Pollard/eff17b74aec032c4f05e66879a61cd158ddda70d
Description
Manual Therapy for Temporomandibular Disorders: A Review of the Literature.
URL
https://www.scielo.br/j/rdor/a/dV5P7vngMkggzjZqKrCvHsR/?lang=en
Description
Pressure Pain Threshold and Pain Perception in Temporomandibular Disorder Patients: Is There Any Correlation?

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The Association Between Temporomandibular Disorders and Sacroiliac Joint Dysfunction

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