EC Dental Science

Research Article Volume 22 Issue 8 - 2023

Efficacy of ULF-TENS on Muscle Relaxation at 15, 30 and 45 Minutes Time Intervals in TMD Individuals with Myofascial Pain - A Prospective Randomized Clinical Study

Utsavraj Butta1*, Kritika Kanwar Butta2 and Priyanka Basu3

1Department of Oral and Maxillofacial Surgery and Oral Implantology, Dental World Superspeciality Clinics PVT. Limited, West Bengal, India
2Department of Prosthodontics, TMJ and Dental Sleep Medicine, Dental World Superspeciality Clinics PVT. Limited, West Bengal, India
3Department of Periodontics, Dental World Superspeciality Clinics PVT. Limited, West Bengal, India

*Corresponding Author: Utsavraj Butta, Department of Oral and Maxillofacial Surgery and Oral Implantology, Dental World Superspeciality Clinics Pvt. Limited, West Bengal, India.
Received: June 20, 2023; Published: July 03 , 2023



Introduction: Temporomandibular joint disorder pain conditions are consequences of a few factors associated with impaired coordination and incorrect relation with structures involved in temporomandibular joint function and uncontrolled contractions in masticatory muscles. Occlusion plays a vital role in the maintenance of temporomandibular joint health and a developing malocclusion may lead to bite displacement and loss of teeth which significantly affects the functioning of muscle in association with the temporomandibular joint.

It is worth clarifying the efficacy of ULF TENS treatment at the duration of 15, 30, and 45 min at Vth and VIIth cranial nerves and “Prabu’s Point” XIth cranial nerve for treating myofascial pain associated temporomandibular joint disorder.

Method: A total of 30 individuals participated in the study with the age group 18 - 55 years. Subjects were recruited in each group and assessed for their TMJD status:

  • Group 1: (n = 24) individuals with chronic TMJD conditions and systemic disease.
  • Group 2: (n = 06) healthy individuals with no TMJD association and systemic disease.

Results: Results obtained in the study suggested the efficacy of ULF-TENS treatment at the duration of 15, 30, and 45 minutes at the coronoid notch and “Prabu’s Point” for treating myofascial pain associated temporomandibular joint disorder have shown to significantly improve the head and neck muscles activity with decreased pain levels.

Conclusion: Considering the result, it might be concluded that the efficacy of ULF-TENS treatment at 15, 30, and 45 minutes stimulating Vth, VIIth and XIth cranial nerves for treating myofascial pain associated with the temporomandibular joint disorder is significant.

Keywords: ULF-TENS - Ultra-Low Frequency Transcutaneous Electrical Nerve Stimulation; TMJD - Temporomandibular Joint Disorder; Myofascial Pain; Masticatory Muscles; Neuromuscular Dentistry

Keywords: ULF-TENS - Ultra-Low Frequency Transcutaneous Electrical Nerve Stimulation; TMJD - Temporomandibular Joint Disorder; Myofascial Pain; Masticatory Muscles; Neuromuscular Dentistry

  1. Kato MT., et al. “Tens and low-level laser therapy in the management of temporomandibular disorders”. Journal of Applied Oral Science 14 (2006).
  2. Sato S., et al. “Occlusal contact area, occlusal pressure, bite force, and masticatory efficiency in patients with anterior disc displacement of the temporomandibular joint”. Journal of Oral Rehabilitation (1999).
  3. Kamyszek G., et al. “Electromyographic evidence of reduced muscle activity when ULF-TENS is applied to the Vth and VIIth cranial nerves”. Cranio - Journal of Craniomandibular and Sleep Practice3 (2001): 162-168.
  4. Rodrigues Bigaton D., et al. “Activity and asymmetry index of masticatory muscles in women with and without dysfunction temporomandibular”. Electroencephalography and Clinical Neurophysiology 50 (2010): 7-8.
  5. Chellappa D and Thirupathy M. “Comparative efficacy of low-Level laser and TENS in the symptomatic relief of temporomandibular joint disorders: A randomized clinical trial”. Indian Journal of Dental Research1 (2020): 42-47.
  6. Treatment of temporomandibular joint syndrome for relief of cervical spine pain: case report (1982).
  7. Davide Pietropaoli. ANS Effects of ULF-TENS Stimulation in Patients with and Without TMD (2016): 1-3.
  8. Chipaila N., et al. “The effects of ULF-TENS stimulation on gnathology: The state of the art”. Cranio - Journal of Craniomandibular and Sleep Practice2 (2014): 118-130.
  9. Abe S., et al. “Immediate effect of masticatory muscle activity with transcutaneous electrical nerve stimulation in muscle pain of temporomandibular disorders patients”. Journal of Clinical Medicine10 (2020): 1-13.
  10. Khawaja SN., et al. “Infield masticatory muscle activity in subjects with pain-related temporomandibular disorders diagnoses”. Orthodontics and Craniofacial Research1 (2015): 137-145.
  11. Rodrigues D., et al. “Effect of conventional TENS on pain and electromyographic activity of masticatory muscles in TMD patients Efeito da TENS convencional sobre a dor e a atividade eletromiográfica dos músculos mastigatórios em pacientes com DTM”. Brazilian Oral Research 18 (2004).
  12. Cooper BC and Kleinberg I. “Establishment of a temporomandibular physiological state with neuromuscular orthosis treatment affects reduction of TMD symptoms in 313 patients”. Cranio - Journal of Craniomandibular and Sleep Practice2 (2008): 104-117.
  13. Esclassan R., et al. “Optimal duration of ultra low frequency-transcutaneous electrical nerve stimulation (ULF-TENS) therapy for muscular relaxation in neuromuscular occlusion: A preliminary clinical study”. Cranio - Journal of Craniomandibular Practice3 (2017): 175-179.
  14. De Castro-Carletti EM., et al. “Effectiveness of electrotherapy for the treatment of orofacial pain: A systematic review and meta-analysis”. Clinical Rehabilitation (2023).
  15. Xu L., et al. “The Impact of Education and Physical Therapy on Oral Behaviour in Patients with Temporomandibular Disorder: A Preliminary Study”. BioMed Research International (2021).
  16. Neurally Mediated ULF-TENS to Relax Cervical and Upper Thoracic Musculature as an Aid to Obtaining Improved Cervical Posture and Mandibular Posture Anthology Volume 9 (1).
  17. Fertout A., et al. “Management of temporomandibular disorders with transcutaneous electrical nerve stimulation: A systematic review”. Cranio - Journal of Craniomandibular Practice3 (2022): 217-228.
  18. Hsieh YL., et al. “Ultra-low frequency transcutaneous electrical nerve stimulation on pain modulation in a rat model with myogenous temporomandibular dysfunction”. International Journal of Molecular Sciences18 (2021).
  19. Kim H. “Comparison of the effects of transcutaneous electrical nerve stimulation, low level laser, and placebo treatment on temporomandibular joint disorders: a single-blind randomized controlled trial”. Physical Therapy Rehabilitation Science4 (2020): 244-251.
  20. Mummolo S., et al. “Ultra-low-frequency transcutaneous electric nerve stimulation (ULF-TENS) in subjects with craniofacial pain: A retrospective study”. Cranio - Journal of Craniomandibular Practice6 (2020): 396-401.
  21. Zhang Y., et al. “Effect of transcutaneous electrical nerve stimulation on jaw movement-evoked pain in patients with TMJ disc displacement without reduction and healthy controls”. Acta Odontologica Scandinavica4 (2020): 309-320.
  22. De Bragança RMF., et al. “Ultra-low frequency transcutaneous electric nerve stimulation does not affect the centric relation registration”. Cranio - Journal of Craniomandibular Practice1 (2018): 19-28.
  23. Ferreira AP De L., et al. “Short-term transcutaneous electrical nerve stimulation reduces pain and improves the masticatory muscle activity in temporomandibular disorder patients: A randomized controlled trial”. Journal of Applied Oral Science2 (2017): 112-120.
  24. Ries LGK., et al. “Effect of time of contraction and rest on the masseter and anterior temporal muscles activity in subjects with temporomandibular disorder”. Codas2 (2016): 155-162.
  25. Habib SR., et al. “Prevalence and severity of temporomandibular disorders among university students in Riyadh”. Saudi Dental Journal3 (2015): 125-130.
  26. Yamashita A., et al. “Thirty-year follow-up of a TMD case treated based on the neuromuscular concept”. Cranio - Journal of Craniomandibular and Sleep Practice3 (2014): 224-234.
  27. Abd El Hameed Fouda A., et al. “Ph ton The Journal of Oral and Maxillofacial Surgery Ph ton Ultrasonic therapy as an adjunct treatment of temporomandibular joint dysfunction”. The Journal of Oral and Maxillofacial Surgery 117 (2014).
  28. Chipaila N., et al. “The effects of ULF-TENS stimulation on gnathology: The state of the art”. Cranio - Journal of Craniomandibular and Sleep Practice2 (2014): 118-130.
  29. Monaco A., et al. “Comparison between sensory and motor transcutaneous electrical nervous stimulation on electromyographic and kinesiographic activity of patients with temporomandibular disorder: A controlled clinical trial”. BMC Musculoskeletal Disorders (2013): 14.
  30. Stein C., et al. “Transcutaneous electrical nerve stimulation at different frequencies on heart rate variability in healthy subjects”. Autonomic Neuroscience2 (2011): 205-208.
  31. Cooper BC. “International College of Cranio- mandibular Orthopaedics (ICCMO) Temporomandibular Disorder: A position paper of International College of Cranio- mandibular Orthopaedics (ICCMO)”. Cranio3 (2011): 237-244.
  32. Forrester SE., et al. “Neuromuscular function in healthy occlusion”. Journal of Oral Rehabilitation9 (2010): 663-669.
  33. Ainsworth L., et al. “Transcutaneous electrical nerve stimulation (TENS) reduces chronic hyperalgesia induced by muscle inflammation”. Pain1-2 (2006): 182-187.
  34. Kathleen A. “Sluka - Mechanisms and Management of Pain for the Physical Therapist”. (Wolters Kluwer) (2016).
  35. K Wieselmann-Penkner., et al. “A comparison of the muscular relaxation effect of TENS and EMG-biofeedback in patients with bruxism”.
  36. Eble OS., et al. “Transcutaneous Electrical Nerve Stimulation (TENS): Its Short-Term and Long-Term Effects on the Masticatory Muscles Kurz-und Langzeiteffekte der transkutanen Elektroneuro-stimulation (TENS) auf die Kaumuskulatur.
  37. Bazzotti L. “Electromyography tension and frequency spectrum analysis at rest of some masticatory muscles, before and after TENS”. Electroencephalography and Clinical Neurophysiology6 (1997).
  38. Frucht S., et al. Originalarbeit-Klinische Untersuchung Muskelentspannung durch transkutane Elektroneurostimulation (TENS) bei Bruxismus Eine elektromyographische Studie 56 (1995).

Utsavraj Butta., et al. "Efficacy of ULF-TENS on Muscle Relaxation at 15, 30 and 45 Minutes Time Intervals in TMD Individuals with Myofascial Pain - A Prospective Randomized Clinical Study". EC Dental Science 22.8 (2023): 01-15.