Advances in Therapy

, Volume 25, Issue 1, pp 9–16 | Cite as

Treating trismus with dynamic splinting: A cohort, case series

  • David H. Shulman
  • Barry Shipman
  • F. Buck Willis
Article

Abstract

Introduction

The 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.

Methods

We 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.

Results

This 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).

Conclusion

The 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.

Keywords

contracture reduction Dynasplint interincisal distance range of motion 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Dhanrajani PJ, Jonaidel O. Trismus: aetiology, differential diagnosis and treatment. Dent Update. 2002;29:88–92, 94.PubMedGoogle Scholar
  2. 2.
    Dijkstra PU, Kalk WW, Roodenburg JL. Trismus in head and neck oncology: a systematic review. Oral Oncol. 2004;40:879–889.PubMedCrossRefGoogle Scholar
  3. 3.
    Moore PA, Brar P, Smiga ER, Costello BJ. Preemptive rofecoxib and dexamethasone for prevention of pain and trismus following third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99:E1–E7.PubMedCrossRefGoogle Scholar
  4. 4.
    Goldstein M, Maxymiw WG, Cummings BJ, Wood RE. The effects of antitumor irradiation on mandibular opening and mobility: a prospective study of 58 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88:365–373.PubMedCrossRefGoogle Scholar
  5. 5.
    Brunello DL, Mandikos MN. The use of a dynamic opening device in the treatment of radiation induced trismus. Aust Prosthodont J. 1995;9:45–48.PubMedGoogle Scholar
  6. 6.
    Dijkstra PU, Huisman PM, Roodenburg JL. Criteria for trismus in head and neck oncology. Int J Oral Maxillofac Surg. 2006;35:337–342.PubMedCrossRefGoogle Scholar
  7. 7.
    Jansma J, Vissink A, Spijkervet FK, et al. Protocol for the prevention and treatment of oral sequelae resulting from head and neck radiation therapy. Cancer. 1992;70:2171–2180.PubMedCrossRefGoogle Scholar
  8. 8.
    Silverman S. Oral Cancer. 4th ed. Ontario, Canada: BC Decker; 1997.Google Scholar
  9. 9.
    Wang CJ, Huang EY, Hsu HC, Chen HC, Fang FM, Hsiung CY. The degree and time-course assessment of radiation-induced trismus occurring after radiotherapy for nasopharyngeal cancer. Laryngoscope. 2005;115:1458–1460.PubMedCrossRefGoogle Scholar
  10. 10.
    Goldstein M, Maxymiw WG, Cummings BJ, Wood RE. The effects of antitumor irradiation on mandibular opening and mobility: a prospective study of 58 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88:365–373.PubMedCrossRefGoogle Scholar
  11. 11.
    Israel IA, Syrop SB. The important role of motion in the rehabilitation of patients with mandibular hypomobility: a review of the literature. J Craniomandibular Pract. 1997;15:1.Google Scholar
  12. 12.
    Miller EH, Quinn AI. Dental considerations in the management of head and neck cancer patients. Otolaryngol Clin North Am. 2006;39:319–329.PubMedCrossRefGoogle Scholar
  13. 13.
    Hepburn, G. Contracture and stiff joint management with Dynasplint. J Ortho Sports Phys Ther. 1987;8:498–504.Google Scholar
  14. 14.
    MacKay-Lyons M. Low-load, prolonged stretch in treatment of elbow flexion contractures secondary to head trauma: a case report. Phys Ther. 1989;69:292–296.PubMedGoogle Scholar
  15. 15.
    Schenk I, Vesper M, Nam VC. Initial results using extracorporeal low energy shockwave therapy ESWT in muscle reflex-induced lock jaw [in German]. Mund Kiefer Gesichtschir. 2002;6:351–355.PubMedGoogle Scholar
  16. 16.
    Willis B. Post-TBI gait rehabilitation. Applied Neurol. 2007;3:25–26.Google Scholar
  17. 17.
    Dijkstra PU, Sterken MW, Pater R, Spijkervet FK, Roodenburg JL. Exercise therapy for trismus in head and neck cancer. Oral Oncol. 2007;43:389–394.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Healthcare Communications 2008

Authors and Affiliations

  • David H. Shulman
    • 1
  • Barry Shipman
    • 2
  • F. Buck Willis
    • 3
    • 4
  1. 1.Shulman & Associates Physical TherapyTowsonUSA
  2. 2.Mount Sinai Medical Center, Oral SurgeryMiamiUSA
  3. 3.Dynasplint Systems Inc Clinical ResearchSeverna ParkUSA
  4. 4.Texas State UniversitySan MarcosUSA

Personalised recommendations