Maitland Mobilization for Bruxism in Temporomandibular Disorder: Enhancing Pain Threshold, Function, Sleep, and Mouth Opening

Objective: Although Maitland joint mobilization (MJM) of the cervical spine has been widely studied in the treatment of temporomandibular disorders (TMD), limited research exists on its direct application to the temporomandibular joint (TMJ), particularly in patients with bruxism. This study aimed to explore the effectiveness of TMJ-targeted MJM in improving pain pressure threshold (PPT), functional limitation (FL), sleep quality (SQOL), and maximal mouth opening (MMO) in individuals with myofascial TMD associated with bruxism. Material and Methods: This is a single blind, quasi-experimental study with 40 participants allocated to either the control group (Group A; N=20), receiving only conventional exercises, or the experimental group (Group B; N=20), receiving MJM of TMJ with conventional exercises for 4 weeks; 10-cm metal scale was used to measure MMO, a dolorimeter to assess PPT of the masseter, the Mandibular Function Impairment Questionnaire to evaluate FL, and Pittsburgh Sleep Quality Index to assess SQOL. Results: 35 out of the 40 who completed the 4-week intervention were included in the analysis. Baseline demographics were similar between the groups in gender and age (p-value>0.05). The experimental group showed significantly greater improvements in PPT (p-value<0.05), MMO (p-value=0.000), and FL (p-value<0.05) post-intervention. SQOL did not differ significantly between the groups (p-value>0.05). Strong positive correlations were found between PPT and MMO (r=0.873, p-value<0.05), and between FL and SQOL (r=0.715, p-value<0.05). Conclusion: MJM in Bruxism with myofascial TMD effectively improved MMO, PPT (masseter), and FL, but the groups did not exhibit any significant differences in SQOL.