Manual Therapy group
Manual Therapy (MT) applied on the masticatory muscles intra and extra
orally alongside MT of the cervical region were used in treatment of
bruxism. MT brings about benefits by increasing local circulation and
decreasing muscle tonus. Additionally, stretching exercises aiming to
decrease pain and elongate shortened masticatory muscle fibers by
autogenic inhibition of the masseter muscle were also applied.
Extra-oral applications consisted of; emphasis on the masseter and
temporalis muscle using kneading, friction (performed in the direction
of muscle fiber orientation), intramuscular stretching, sliding and
ischemic compression for trigger point release. Myofascial release
techniques were used to eliminate pain. Additionally, active and passive
exercises were applied on the masseter, temporalis, digastric, medial
pterygoid and lateral pterygoid muscles. Intra-oral applications
consisted of; emphasis on the masseter muscles using kneading, friction
(performed in the direction of muscle fiber orientation), intramuscular
stretching and sliding, and ischemic compression for trigger point
release. Applications of the cervical region consisted of; upper
cervical flexion mobilization, C2-C5 central posterior-anterior
mobilization, and also kneading, friction (performed in the direction of
muscle fiber orientation), intramuscular stretching and sliding
maneuvers for the cervical muscles [25]. MT was performed by a
physiotherapist certified in MT.