Szymon Tyszkiewicz, Marcin Kozakiewicz, Marta Tyndorf, Dorota Kościelniak

S. Tyszkiewicz, M. Kozakiewicz, M. Tyndorf, D. Kościelniak – Evaluation of the effectiveness of manual techniques and dynamic taping in the reduction of postoperative complications after surgical treatment of orthognathic defects. Fizjoterapia Polska 2019; 19(3); 146-157

Abstract
Aim of the study. Evaluation of the effectiveness of manual techniques and dynamic taping in the reduction of postoperative complications after surgical treatment of orthognathic defects.
Material and methods.50 people were qualified for the tests. These people were between the ages of 16 and 39. They were rehabilitated as a result of the surgical treatment of orthognathic defects. These patients were hospitalized due to postoperative complications such as tissue contractures, adhesions and scars, disturbances in joint mobility of the temporomandibular region and the cervical spine, lymphatic edema and nerve conduction disorders in the facial area. In a few people, additional blood bruising was found.
Dynamic taping was performed for two weeks postoperatively, treatments with massage and manual therapy twice a week (45-60 min. – time of a particular visit) for a period of 3 months, starting from the first week after surgery. The results of the therapy were supported by patients performing the recommended exercises. The rate and amount of edema reduction were assessed. Changes in the movement of temporomandibular joints and complex movement of the cervical spine were measured. The rate and extent of reinnervation and the level of pain were controlled. The Pietruski’s, House and Brackmann’s scales, VAS and linear measurements were used for the assessment.
Results.The average range of mobility in the field of temporomandibular joints and the cervical spine was improved in all examined spatial axes. The edema was significantly reduced, remaining after 3 months of therapy only at the averaged value of 8% of the baseline value.Sensory as well as motor fibers in the reinnervation process regained their functions. Their average state described by Pietruski’s scale results is about 26 points, which in the descriptive assessment corresponds to a small paresis.Post-operative haematomas were absorbed within two weeks of the operation.Pain in patients decreased from 7 points at the beginning of therapy, to 3 points after three weeks (average values). The total reduction occurred on average after 5 weeks.
Conclusions. The therapeutic process carried out had a significant influence on the results achieved. These data are comparable with the results presented in the scientific literature, describing similar issues. The results achieved are statistically significant (p <0.05), referring them to the results of people in the comparative group. As a result of the implemented comprehensive therapy, biomechanics and mobility in temporomandibular joints and spine joints were restored to physiological conditions. The performance of the lymphatic system has increased. The pain sensations have been reduced. There were no significant disturbances in the area of facial expressions and the work of sensory branches on the face. Fascial adhesions and scars have been released, to a condition that does not hinder the return to normal daily activity.

Key words:
orthognathic defects, dental physiotherapy, manual therapy, dynamic taping