Tongqei Zhu, Qingmin Niu. Physical therapy dept., Wuji county hospital, Hebei province, China

Temporomandibular pain and dysfunction syndrome (TMPDS) is one of the common form of mandible disorder.  It is typified by pain in the temporomandibular joint (TMJ) and muscles of mastication, limited or deviant opening of the mandible and or joint sounds. In order to improve the treatment of TMPDS, F.I.T. TDP therapy was employed to twenty-two patients and satisfactory results were obtained.

OVERVIEW

Of the twenty-two patients, thirteen of them were male and nine were female. Their ages ranged from twenty years old to sixty-two years old. The shortest duration of the illness was two days and the longest duration was four months. The period of TDP irradiation therapy ranged low from two days to high thirty days. All twenty-two patients exhibited unilateral or bilateral TMJ pain, limited or deviant opening of the mandible and joint sounds. In nineteen patients (n=22), only unilateral TMJ was exhibited. Bilateral TMJ pain existed in other three patients. Prior to commencement of TDP irradiation therapy, the steroid drugs and local block therapy had been administrated to one patient and Helium-Neon laser irradiation spectrum therapy had been employed on another patient. Neither patient exhibited any therapeutic benefit from those treatments. To observe the therapeutic effects of MF-TDP irradiation, all other treatments were stopped during TDP irradiation therapy.

Method

A TDP irradiation therapeutic device (made in Chong Qing, China) was used for the therapy. The machine was pre-warmed for five to ten minutes before the treatment. The patients, wearing colored spectacles, lay on the side opposite the TMPDS site. The TMJ was irradiated by a beam directed from the TDP machine to the TMJ. The distance between the irradiation source and the TMJ was thirty to forty centimeters. The TDP was adjusted to the limitation that the patient felt comfortable (about 40 C). The irradiation therapy was provided to each patient for forty minutes per day.

Standards

The standards for evaluation of the TDP therapy were first, if the pain was relieved, the joint sound disappeared and the limited or deviant opening of mandible was corrected, the TMPDS was considered to be cured. Second, if the pain was abated, but the joint sound sometime still could be heard and the mandible function returned to normal, the TMPDS was considered to be improved. Third, if the pain abated, the joint sound sometime was able to be heard and the mandible function was improved, the TMPDS was considered better. Fourth, if all symptoms remained unchanged, the TMPDS was considered no improved.

Result

Of these twenty-two cases, ten patients (45%) were considered to be cured; six patients (27%) improved; four patients had better TMJ function better and two patients remained unchanged. The overall improvement rate is 72%. The overall better rate is 91%.

Discussion

The etiology of TMPDS is rather complicated. It might be related with personality disorders, occlusal disharmony, trauma, dental irritation and anatomic abnormalities. According to the pathological changes, the TMPDS can be classified into three types: (1) functional disorders; (2) joint structure disorder diseases; (3) joint destructive diseases. Psychophysiology problems, neurasthenia and fatigue are considered to be the causes of TMJ functional disorder (the first type of TMPDS). They can result in an imbalance of the muscles' excitement and inhibition. It is postulated that the essence of the phenomena might be connected with a possible imbalance of trace elements which is necessary to the proper TMJ function.

The TDP plate is coated with thirty-three elements ( new version has more). When the plate is heated to 400-600 C, these elements are agitated and emit their own specific electromagnetic waves. When the patient is exposed to the TDP irradiation, the special electromagnetic waves will be selectively absorbed by the body. Therefore, the unbalanced elements ratio will be rebuilt. Consequently, the muscle's functions are adjusted and the symptoms will be relieved. As other researchers indicate, the special electromagnetic wave can adjust the metabolism, enhance the auto regulation mechanism and immune functions. It can also improve the micro circulation, diminish inflammation, relieve pain.

In this group, all twenty-two patients were diagnosed as TMPDS. No structure disorder and destructive changes were found. We classified them as first type (functional disease) TMPDS. We employed TDP therapy on these patients and obtained a good result. Two patients had no any improvement. One had chronic back pain accompanied with shoulder joint arthritis. We considered his TMPDS may be caused by senile degenerative disorder. The other patient was later diagnosed as a tumor of mandible. These results indicate that the functional disorder is the most suitable for TDP irradiation therapy. Before TDP irradiation therapy, a through examination must be made to eliminate malignant disease.