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An Osteopathic Approach to Temporomandibular Dysfunction Secondary to A Motor Vehicle Accident

Journal: The AAO Journal Date: 2024/06, 34(2):Pages: 23. doi: Subito , type of study: case report

Full text    (https://meridian.allenpress.com/aaoj/article/34/2/16/500954/LBORC-NUFA-Poster-Abstracts-2024-Students)

Keywords:

accident [26]
case report [702]
geriatrics [103]
male [744]
OMT [3730]
osteopathic manipulative treatment [3750]
temporomandibular dysfunction [48]
trauma [117]

Abstract:

Introduction/Background: Temporomandibular joint dysfunction (TMD) can occur from trauma among other causes and manifests as jaw pain, difficulty chewing, and/ or lock jaw. The mainstay treatments are injections and surgery; however Osteopathic Manipulative Treatment (OMT) is a less explored approach and has minimal evidence in the literature that may offer a less invasive and promising alternative. Case: A 67-year-old male status post motorcycle accident in November 2022 with jaw fractures in 5 locations presented to the Osteopathic Treatment Center with tinnitus, head injury, jaw pain with posterior right premature contact, and painful chewing. Initially the patient was treated with maxillomandibular fixation and pins placed for eight weeks followed by intraoral OMT; in addition to intraoral, osteopathic cranial manipulative medicine (OCMM) was implemented first followed by soft tissue, direct myofascial release, and Still technique. Results: Disability percentage, measured using the TMD Disability Index Questionnaire, decreased from 68% pre-treatment to 10% post-treatment. In addition, improvement was noted in jaw alignment, consisting of less translation and compression of the right temporomandibular joint which improved consumption of foods that were previously not tolerated. Two days posttreatments, the patient reported a decrease in frequency of headaches and jaw pain. Discussion: This case study suggests that OMT can improve the quality of life for patients with TMD secondary to trauma. The use of cranial techniques followed by head and neck treatments was effective management approach for this patient with TMD pain. Treatment with OCMM yielded significantly improved results when evaluating the Cranial Rhythmic Impulse compared to previous treatment without OCMM as evidenced by further decrease in disability percentage. A limitation to the study was the subjectivity of the disability index.


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