Effect of jaw-opening exercise on prevention of temporomandibular disorders pain associated with oral appliance therapy in obstructive sleep apnea patients:

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Effect of jaw-opening exercise on prevention of temporomandibular disorders pain associated with oral appliance therapy in obstructive sleep apnea patients: A randomized, double-blind, placebo-controlled trial Hiroyuki Ishiyama, DDS, Shusuke Inukai, DDS, PhD, Akira Nishiyama, DDS, PhD, Masayuki Hideshima, DDS, PhD, Shuhei Nakamura, DDS, PhD, Meiyo Tamaoka, MD, PhD, Yasunari Miyazaki, MD, PhD, Kenji Fueki, DDS, PhD, Noriyuki Wakabayashi, DDS, PhD Journal of Prosthodontic Research Volume 61, Issue 3, Pages 259-267 (July 2017) DOI: 10.1016/j.jpor.2016.12.001 Copyright © 2017 Japan Prosthodontic Society Terms and Conditions

Fig. 1 Time line in this study. Journal of Prosthodontic Research 2017 61, 259-267DOI: (10.1016/j.jpor.2016.12.001) Copyright © 2017 Japan Prosthodontic Society Terms and Conditions

Fig. 2 Jaw-opening exercise (JE-group): all fingers, except for the thumb, on the dominant hand were placed on the edge of the mandibular incisors, and the thumb of the opposite hand was placed on the edge of the maxillary incisors. The subjects opened their mouth with finger effort until they felt masticatory muscle tightness. The opened position was held for 10s. Journal of Prosthodontic Research 2017 61, 259-267DOI: (10.1016/j.jpor.2016.12.001) Copyright © 2017 Japan Prosthodontic Society Terms and Conditions

Fig. 3 Neck exercise (placebo) (PE-group): first, the patient rotated the head to the right side and set the right hand on the superior part of the left ear, then slowly pressed against the head with the right hand, and extended the neck until they felt the tightness of the muscles. The extended position was held for 10s. Journal of Prosthodontic Research 2017 61, 259-267DOI: (10.1016/j.jpor.2016.12.001) Copyright © 2017 Japan Prosthodontic Society Terms and Conditions

Fig. 4 CONSORT flow diagram. Journal of Prosthodontic Research 2017 61, 259-267DOI: (10.1016/j.jpor.2016.12.001) Copyright © 2017 Japan Prosthodontic Society Terms and Conditions

Fig. 5 VAS scores for TMD pain intensity at (a) 2-weeks and (b) 1-month and (c) 3-months after OA insertion (*P<0.05). Journal of Prosthodontic Research 2017 61, 259-267DOI: (10.1016/j.jpor.2016.12.001) Copyright © 2017 Japan Prosthodontic Society Terms and Conditions

Fig. 6 Percentage of subjects using OA every day (%) (a) and percentage of subjects wearing OA all night (%) (b) at 2-weeks (2W), 1-month (1M) and 3-months (3M) after OA insertion. Journal of Prosthodontic Research 2017 61, 259-267DOI: (10.1016/j.jpor.2016.12.001) Copyright © 2017 Japan Prosthodontic Society Terms and Conditions