Effects of Mulligan Mobilization in Comparison With Maitland Mobilization in Temporomandibular Joint Dysfunction.

Effects of Mulligan Mobilization in Comparison With Maitland Mobilization in Temporomandibular Joint Dysfunction

The temporomandibular joint dysfunction is the second most common musculoskeletal pain after back pain, causing jaw pain, restricted movement, and joint sounds. NPRS and millimeter ruler will be used for the assessment of patient. This study will compare the effects of Mulligan and Maitland mobilization, commonly used treatment, on pain and Temporomandibular joint mobility through a randomized controlled trial, involving 30 participants divided into two groups for treatment.

The temporomandibular joint connects the mandible to the temporal bone near the ear's tragus and plays a key role in mastication. It involves joint or muscle pain, jaw movement limitation, and joint popping sound Risk factors include trauma, bruxism, arthritis, stress, and poor posture, while diagnosis is commonly made using the DC/TMD criteria, focusing on pain and intra-articular dysfunction. Manual therapy techniques widely used to restore joint function and reduce pain.

Among these, Mulligan's Mobilization combines therapist-applied glides with active patient movement, while Maitland mobilization uses graded oscillatory techniques to relieve pain and improve mobility.

This study aims to compare the effects of Mulligan and Maitland mobilization on pain reduction and TMJ hypomobility in adults with TMD.

A randomized controlled trial will be conducted over one year. 30 participants will be selected through purposive sampling and randomly divided into two groups.

The intervention will last two weeks, comprising 06 treatment sessions. Assessments will be conducted at baseline, after the third session, and at the end of the second week.

Treatment will include lateral, anterior, medial, and distraction glides, combined with Rocabado's 6x6 exercises to improve functional movement. Myofascial release for the temporalis and masseter muscles will also be applied.

Inclusion criteria

• Age 19-44 years.
• Both Genders (Male and Female).
• Patients diagnosed with TMJ hypomobility using the Manual Functional Analysis questionnaire based on DC/TMD criteria.
• Individuals with myofascial pain, scoring above 5 on the NRS and pain upon palpation of at least two of eight masticatory and neck muscles.
• Subjects with acute TMD and myofascial pain unrelated to active inflammation, infection, or recent trauma for at least six months.

Exclusion criteria

• Hypermobility of TMJs.
• Pregnancy.
• History of rheumatic and inflammatory diseases.
• A history of temporomandibular disorders treatment within last three months.
• Acute trauma or injuries of face, head or cervical spine, neurological disorders, taking medication that could affect the musculoskeletal system.