Treating trismus with dynamic splinting: A cohort, case series

IntroductionThe purpose of this study was to retrospectively evaluate the effect of the Dynasplint® Trismus System (DTS; Dynasplint Systems Inc, Severna Park, Md, USA) for patients who were recently diagnosed with trismus following radiation therapy, dental treatment, oral surgery, or following a neural pathology such as a stroke.MethodsWe reviewed 48 patient histories (treated in 2006–2007), and divided into 4 cohort groups (radiation therapy for head/neck cancer, dental treatment, oral surgery, or stroke), to measure the efficacy of this treatment’s modality. Patients were prescribed the DTS after diagnosis of trismus based on examination that showed <40 mm maximal interincisal distance. The DTS uses low-load, prolonged-duration stretch with replicable, dynamic tension to achieve longer time at end range (of motion). Each patient used this device for 20–30 min, 3 times per d.ResultsThis cohort case series showed that there was a statistically significant difference within all patient groups (P<0.0001; t=10.3289), but there was not a significant difference between groups (P=0.374).ConclusionThe biomechanical modality of DTS with a low-load, prolonged-duration stretch was attributed to the success in reducing contracture in this study. This improved range of motion, allowing patients to regain the eating, hygiene and speaking patterns they had before developing trismus.

[1]  George R. Hepburn,et al.  Case Studies: Contracture and Stiff Joint Management with Dynasplint™* , 1987 .

[2]  M. MacKay-Lyons Low-load, prolonged stretch in treatment of elbow flexion contractures secondary to head trauma: a case report. , 1989, Physical therapy.

[3]  A. Vissink,et al.  Protocol for the prevention and treatment of oral sequelae resulting from head and neck radiation therapy , 1992, Cancer.

[4]  The use of a dynamic opening device in the treatment of radiation induced trismus. , 1995, Australian prosthodontic journal.

[5]  The use of a dynamic opening device in the treatment of radiation induced trismus. , 1995 .

[6]  H. Israel,et al.  The important role of motion in the rehabilitation of patients with mandibular hypomobility: a review of the literature. , 1997, Cranio : the journal of craniomandibular practice.

[7]  M. Goldstein,et al.  The effects of antitumor irradiation on mandibular opening and mobility: a prospective study of 58 patients. , 1999, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[8]  P. Dhanrajani,et al.  Trismus: aetiology, differential diagnosis and treatment. , 2002, Dental update.

[9]  [Initial results using extracorporeal low energy shockwave therapy ESWT in muscle reflex-induced lock jaw]. , 2002, Mund-, Kiefer- und Gesichtschirurgie : MKG.

[10]  Erste Erfolge unter Anwendung der extrakorporalen niederenergetischen Stoßwellentherapie ESWT bei muskelreflektorischer Kieferklemme , 2002, Mund-, Kiefer- und Gesichtschirurgie.

[11]  J. Roodenburg,et al.  Trismus in head and neck oncology: a systematic review. , 2004, Oral oncology.

[12]  P. Moore,et al.  Preemptive rofecoxib and dexamethasone for prevention of pain and trismus following third molar surgery *. , 2005, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[13]  F. Fang,et al.  The Degree and Time‐Course Assessment of Radiation‐Induced Trismus Occurring After Radiotherapy for Nasopharyngeal Cancer , 2005, The Laryngoscope.

[14]  E. Miller,et al.  Dental considerations in the management of head and neck cancer patients. , 2006, Otolaryngologic clinics of North America.

[15]  J. Roodenburg,et al.  Criteria for trismus in head and neck oncology. , 2006, International journal of oral and maxillofacial surgery.

[16]  Post-TBI Gait Rehabilitation , 2007 .

[17]  J. Roodenburg,et al.  Exercise therapy for trismus in head and neck cancer. , 2007, Oral oncology.