Chandrika G.Katti et al./ Elixir Dentistry 68 (2014) 22600-22603 22600 Introduction The temporomandibular joint is a hinge joint that connects the lower jaw to the temporal bone of the skull. It is one of the most frequently used joints in the human body. It is not only used while talking, chewing, yawning, swallowing and other normal activities, but even during sleep. The frequency of movement is assessed as approximately 1500–2000 times a day. 1 A Temporomandibular disorder (TMD) is a musculoskeletal disorder within the masticatory system. TMDs are defined by the American Academy of Orofacial Pain as “a collective term that embraces a number of clinical problems that involve the masticatory muscles, the TMJ(temporomandibular joint), and the associated structures. 2 TMD’s occur as a result of problems with the jaw, jaw joint, and surrounding facial muscles that control chewing and moving the jaw. According to epidemiological studies, 70% of the population suffers from at least one symptom or sign of TMD, but only one 1/4th of this number is aware of it and only 5% seek medical treatment. 1 The complex array of symptoms and disability a person suffers often can lead them to feel that their condition is too difficult, frustrating, and elusive to treat. Common signs and symptoms of TMD’s include; 1. Pain or tenderness in the temporomandibular joint, muscles of mastication, facial areas, ear region, shoulder and neck. 2. A clicking, popping or grating sound when opening or closing the mouth or while chewing. 3. Catching or locking or limitations of the joint with deviations or deflections of the mandible when opening or closing the mouth. 4. Difficulty or discomfort while chewing. 5. Sensation of an uncomfortable bite. 3,4 It is essential to start treatment at the stage of mere dysfunction, i. e. at the stage when the changes are still reversible, in order to prevent irreversible structural changes. Physical therapy comprises a group of supportive actions that is performed in conjunction with definitive treatment. 5,6 They can be broadly grouped into physical modalities and manual techniques though they work best in combination. Physical therapy represents the physical treatment that can be applied to the patient. 7,8 It includes modalities like thermotherapy, coolant therapy, ultrasound, electrogalvanic stimulation, transcutaneous electrical nerve stimulation, iontophoresis, phonophoresis, acupuncture, and laser therapy. Manual therapy comprises of various techniques like stretching, mobilizations, and manipulations of the TMJ and cervical spine, exercise instruction (i.e., self-stretching and mobility strategies for the TMJ and cervical spine); patient education (i.e., postural instruction, relaxation techniques, and parafunctional awareness); and other modalities that improve tissue health.Katsoulis J and Richter M demonstrated that TMD patients who undertook specific physical therapy and regularly practiced self-physical therapy succeeded in relaxing their masticatory muscles and in decreasing the level of pain. 9 Another clinical trial conducted by Madani and Mirmortazavi on patients with TMD highlighted the importance of physical therapy in pain relief. 10 Treatment Modalities Thermotherapy/Heat treatment:It is one of the most commonly used modalities to treat pain related to TMD. The basic mechanism behind thermotherapy is that it causes vasodilatation in the compromised tissues thereby improving the circulation and relieving the myalgia and muscles soreness. It also helps in increasing the extensibility of periarticular tissue.A hot water bottle wrapped in a hot, moist towel or an electric heating pad placed over the offending area for 10-15 minutes will provide the required amount of surface heat. 11 Moist heat penetrates to depths of 1-2cm. It is better than dry heat because Physiotherapeutical modalities in the treatment of temporo mandibular disorders- a review Chandrika G.Katti 1 , Girish Katti 2 , Jayesh J. Unnithan 2 , Sreenivas Rao Ghali 2 and Syed Shahbaz 2 1 Department of Orthodontics, Al-badar Dental College & Hospital, Gulbarga, Karnataka. 2 Department of Oral Medicine & Radiology, Al-Badar Dental College & Hospital,Gulbarga, Karnataka. ABSTRACT Temporomandibular disorders (TMD) occur as a result of problems with the jaw, TM joint, and surrounding facial muscles that control chewing and the movement ofthe jaw.Patients affected by TMD’s present an array of symptoms which include jaw or neck pain, headache, and clicking or grating within the joint. The objective of comprehensive TMD management is not only relief of pain, but the rehabilitation or return of the entire masticatory apparatus to optimum physiologic function. The rationale for such an approach is to minimize the likelihood of exacerbations & chronicity, which are common in TMD. As our dental curricula provide nominal training in TMD management, most dentists have limited understanding of these disorders and its management. Similarly therapists also have little understanding of the importance of the dental role in management of these disorders. Hence treatment of TMD requires an interdisciplinary approach of appropriate and effective dental therapy combined with well executed physiotherapy. Physiotherapy includes modalities (e.g., Iontophoresis, Phonophoresis), relaxation techniques, and complementary therapies (e.g., Acupuncture, Hypnosis) which are used for the treatment of temperomandibular joint disorders and have proven to provide good results. © 2014 Elixir All rights reserved ARTICLE INFO Article history: Received: 13 December 2013; Received in revised form: 10 March 2014; Accepted: 20 March 2014; Keywords TMD, Physiotherapeutic, TENS therapy. Elixir Dentistry 68 (2014) 22600-22603 Dentistry Available online at www.elixirpublishers.com (Elixir International Journal) Tele: E-mail addresses: mypublicationdev@gmail.com © 2014 Elixir All rights reserved