Evaluation of masticatory muscle function in the treatment dynamics of patients with myofascial pain syndrome

Relevance. Myofascial pain syndrome (MPS) often progresses to a chronic form that is challenging to treat with established methods. This issue is well known to dentists and frequently leads to frustration despite significant efforts to advance knowledge in the fields of etiopathogenesis, diagnosis, and therapy. Most treatment protocols focus on normalizing physiological parameters, such as restoring masticatory function, achieving stable occlusal relationships, alleviating pain, and enhancing the psychological well-being of these patients. Therefore, the need for non-invasive diagnostics to assess functional activity and monitor the condition of masticatory muscles during treatment is crucial. This study aims to address this need.

Materials and methods. The examination and treatment of 64 patients with myofascial pain syndrome were conducted in two stages—clinical and electromyographic. During the clinical examination, tenderness of the masticatory muscles during palpation and the degree of mouth opening were assessed. The electromyographic research was also conducted in two stages. The first stage assessed the average amplitude and total biopotential of the masticatory and temporal muscles on both the right and left sides. The second stage evaluated the symmetry index of the masticatory muscles, as well as torsion and masseter indices. The first group received conventional treatment combined with laser therapy, while the second group received ozone therapy and kinesiology taping in addition to the conventional therapy.

Results. In the short-term observations over 14 days, both groups achieved positive results. However, patients undergoing ozone therapy and kinesiology taping showed statistically significant improvements in their parameters by the third day of observation compared to their baseline values.

Conclusion. For diagnosing this pathology, it is advisable to incorporate electromyography into the examination protocol to allow non-invasive evaluation of the functional activity of the masticatory muscles. For treating myofascial pain syndrome, minimally invasive methods with anti-inflammatory, analgesic, and muscle relaxant effects are recommended. While all treatment methods yielded favorable results, ozone therapy combined with kinesiology taping effectively eliminated both subjective and objective symptoms in this patient category.

1. Makedonova Y.A., Vorobyov AA, Aleksandrov AV, Dyachenko DYU, authors; VolSMU, patent holder. Screening diagnosis of masticatory muscle hypertonia in adults. Svid. O Register. databases 2021621703 Ros. Federation. Publ. 11.08.2021. (In Russ). Available from: https://www.elibrary.ru/item.asp?id=46471398

2. Moola S, Munn Z, Tufanaru C, Aromataris E, Sears K, Sfetcu R, et al. Systematic reviews of etiology and risk. In: Aromataris E, Munn Z, editors. JBI Reviewer’s Manual. 2020:219-271 doi: 10.46658/jbimes-20-08

3. Butts R, Dunning J, Pavkovich R, Mettille J, Mourad F. Conservative management of temporomandibular dysfunction: A literature review with implications for clinical practice guidelines (Narrative review part 2). J Bodyw Mov Ther. 2017;21(3):541-548. doi: 10.1016/j.jbmt.2017.05.021

4. Kopacz Ł, Ciosek Ż, Gronwald H, Skomro P, Ardan R, Lietz-Kijak D. Comparative Analysis of the Influence of Selected Physical Factors on the Level of Pain in the Course of Temporomandibular Joint Disorders. Pain Res Manag. 2020;10;2020:1036306. doi: 10.1155/2020/1036306

5. Rongo R, Ekberg E, Nilsson IM, Al-Khotani A, Alstergren P, Conti PCR, Durham J, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for children and adolescents: an international delphi study – Part 1. Development of axis I. J Oral Rehabil. 2021;48(7):836-845. doi: 10.1111/joor.13175

6. Urbański P, Trybulec B, Pihut M. The Application of Manual Techniques in Masticatory Muscles Relaxation as Adjunctive Therapy in the Treatment of Temporomandibular Joint Disorders. Int J Environ Res Public Health. 2021;18(24):12970. doi: 10.3390/ijerph182412970/

7. Makedonova YuA, Iarygina EN, Alexandrov AV, Chizhikova TМ, Devyatchenko LA, Filimonova ON. Gradation of the severity of hypertonicity of the masticatory muscles. Endodontics Today. 2024;22(1):80-85 (In Russ.). doi: 10.36377/ET-0006

8. Osiewicz M, Lobbezoo F, Ciapała B, Pytko-Polończyk J, Manfredini D. Pain Predictors in a Population of Temporomandibular Disorders Patients. J Clin Med. 2020;9(2):452. doi: 10.3390/jcm9020452

9. Andre A, Kang J, Dym H. Pharmacologic Treatment for Temporomandibular and Temporomandibular Joint Disorders. Oral Maxillofac Surg Clin North Am. 2022;34(1):49-59. doi: 10.1016/j.coms.2021.08.001

10. Yatsuk AV, Sivolapov KA. Treatment and rehabilitation of patients with temporomandibular joints pathology. RUDN Journal of Medicine. 2023;27(1):110–118. doi: 10.22363/2313-0245-2023-27-1-110-118

11. Simoen L, Van den Berghe L, Jacquet W, Marks L. Depression and anxiety levels in patients with temporomandibular disorders: comparison with the general population. Clin Oral Investig. 2020;24(11):3939-3945. doi: 10.1007/s00784-020-03260-1

12. Makedonova YuA, Vorobyev AA, Osyko AN, Alexandrov AV, Pavlova-Adamovich AG, Gatsenko SM. Comparative analysis of method effectiveness for relieving masticatory muscle hypertonicity in children with cerebral palsy. Parodontologiya. 2022;27(4):318-326 (In Russ.). doi: 10.33925/1683-3759-2022-27-4-327-335

13. Petrikas IV, Kurochkin AP, Trapeznikov DV, Isсhanova AV, Fayzulova EB. A comprehensive approach to treatment of neuromuscular dysfunctional syndrome of the temporal mandibular joint (tmj). Clinical observation. Actual problems in dentistry. 2018;14(1):66-70e (In Russ.). doi: 10.24411/2077-7566-2018-100013

14. Manfredini, Lombardo L, Siciliani G. Temporomandibular disorders and dental occlusion. A systematic review of association studies: end of an era? Journal of Oral Rehabilitation. 2017;44(11):908–923. doi: 10.1111/joor.12531

15. Сanales GT, Guarda-Nardini L, Rizzatti-Barbosa CM, Conti PCR, Manfredini D. Distribution of depression, somatization and pain-related impairment in patients with chronic temporomandibular disorders. J Appl Oral Sci. 2019;27:e20180210. doi: 10.1590/1678-7757-2018-0210

16.