Year 2019, Volume 48, Issue 1

Physiotherapy treatment in mouth opening limitation after orthognathic surgery: a case report

Conesa-Mendoza M, Muñoz-Ángel AM.


Background: orthognathic surgery is performed to correct severe skeletal open bites. A complication that may occur is trismus, restricting mouth opening. Objective: the purpose of this study is to describe several techniques used, as well as the results obtained in temporomandibular joint mobility and pressure pain sensitivity, with manual therapy and invasive treatment combined with home-therapeutic exercise regimen. Case report: descriptive study of the case of a 43-year old woman with an important reduction in mouth opening and lack of sensitivity in chin area 10 months after surgery. The patient had no pain in mandibular opening or lateral movements, however several trigger points in mandibular muscles were evidenced causing limited movement with a soft end-feel. A total of 6 sessions were given applying manual therapy and invasive treatment. Therapeutic home-exercise based on myofunctional therapy was also prescribed to restore muscle tone. Results: after treatment a significant clinical improvement was evidenced, achieving a normal mouth opening and regularizing mandibular dynamics, as well as a decrease in pressure pain sensitivity and an increased sensitivity in chin area. Conclusion: this approach can be considered an effective postsurgical treatment for maxillofacial pathology

Keywords: manual therapy, physical therapy specialty, orthognathic surgery, trismus, trigger points.