title: Effects of massage therapy and occlusal splint therapy on mandibular range of motion in individuals with temporomandibular disorder: a randomized clinical trial.
abstract: OBJECTIVE
  The purpose of this study was to investigate the effects of massage therapy compared with occlusal splint therapy on mandibular range of motion (ROM) in individuals with temporomandibular disorder (TMD) and compare the results with ROM obtained in a group of individuals without this disorder.
  
  
  METHODS
  A blinded randomized clinical trial was conducted. Twenty-eight volunteers with TMD were randomly distributed into either a massage therapy group or an occlusal splint group. Both treatments were provided for 4 weeks. Fourteen individuals without TMD were consecutively allocated to a comparison group. Fonseca anamnestic index was used to characterize TMD and allocate the volunteers to either of the intervention groups or asymptomatic comparison group. Mandibular ROM was evaluated before and after treatment using a digital caliper. Two-way repeated-measures analysis of variance with a post hoc Bonferroni testing was used for intergroup and intragroup comparisons (level of significance was set to 5%). Cohen d was used to calculate the effect size.
  
  
  RESULTS
  In the intragroup analysis, significant increases in ROM were found for all measures in both the massage and occlusal splint groups (P < .05). A small to moderate clinical effect of treatment with the occlusal splint was found regarding right and left lateral excursion in comparison with the massage therapy and asymptomatic comparison groups (0.2 <d < 0.5).
  
  
  CONCLUSIONS
  Massage therapy on the masticatory muscles and the use of an occlusal splint lead to an increase in mandibular ROM similar to that of the asymptomatic comparison group with regard to maximum active mouth opening and both right and left excursion in individuals with TMD.
authors.affiliation: Doctoral Student, Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University, São Paulo, Brazil.
authors.forename: Cid André Fidelis de Paula
authors.initials: CA
authors.lastname: Gomes
authors.affiliation: Professor, Physical Therapy Program, Nove de Julho University, São Paulo, Brazil.
authors.forename: Fabiano
authors.initials: F
authors.lastname: Politti
authors.affiliation: Doctoral Student, Postgraduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil.
authors.forename: Daniel Ventura
authors.initials: DV
authors.lastname: Andrade
authors.affiliation: Master's Student, Postgraduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil.
authors.forename: Dowglas Fernando Magalhães
authors.initials: DF
authors.lastname: de Sousa
authors.affiliation: Master's Student, Postgraduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil.
authors.forename: Carolina Marciela
authors.initials: CM
authors.lastname: Herpich
authors.affiliation: Doctoral Student, Postgraduate Program in Rehabilitation and Functional Performance, University of São Paulo, Ribeirão Preto, Brazil. Electronic address: dibaifilho@gmail.com.
authors.forename: Almir Vieira
authors.initials: AV
authors.lastname: Dibai-Filho
authors.affiliation: Professor, Physical Therapy Program, Nove de Julho University, São Paulo, Brazil.
authors.forename: Tabajara de Oliveira
authors.initials: Tde O
authors.lastname: Gonzalez
authors.affiliation: Professor, Postgraduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil.
authors.forename: Daniela Aparecida
authors.initials: DA
authors.lastname: Biasotto-Gonzalez
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000503:physiopathology*; D008405:Massage; D017090:Occlusal Splints; D016059:Range of Motion, Articular; D016037:Single-Blind Method; D013705:Temporomandibular Joint Disorders / Q000503:physiopathology* / Q000628:therapy*; D055815:Young Adult
keywords: Facial Pain; Orthodontic Appliances; Physical Therapy Modalities