Temporomandibular joint (TMJ) involvement is common in Systemic Sclerosis (SSc), leading to significant functional limitations and pain. Few studies have addressed the structural and functional changes in the TMJ using imaging, and treatment options have rarely been explored. This study aimed to evaluate the effects of two physiotherapy protocols specifically designed to improve TMJ function in SSc patients. The study included 26 outpatients with SSc (22 females, 4 males; average age 59.1 years), randomly assigned to two different treatment protocols. Protocol 1 included home-based TMJ exercises, while Protocol 2 combined these exercises with an additional physiotherapeutic procedure. Ultrasound (UE) assessments were performed before treatment, after completion, and at an 8-week follow-up to observe any structural or functional changes in the TMJ during static and dynamic movements.
Results indicated that both treatment protocols significantly improved mouth opening ability (p < 0.01 for Protocol 1, p < 0.005 for Protocol 2), with a sustained effect even at follow-up. Protocol 2 demonstrated superior efficacy, yielding greater improvement in TMJ function and a significant increase in the bilateral condyle-head temporal bone distance as observed via ultrasound. These gains were maintained through the follow-up period in the Protocol 2 group.
In conclusion, rehabilitation programs that combine home-based exercises with additional physiotherapy procedures can be effective in restoring TMJ function in SSc patients, with Protocol 2 providing more sustained benefits. This study also highlights the value of ultrasound in evaluating TMJ health and tracking therapeutic effectiveness in SSc rehabilitation.
