Efficiency of different treatment modalities on radiation induced trismus for maxillofacial cases: a parallel randomized clinical trial

Abstract Background For more than 80% of patients with head and neck cancer, radiation therapy (RT) is a crucial component of their treatment plane which causes impairment for the masticatory apparatus functions leading to trismus. The study objective was to compare the efficacy of different treatme...

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Main Authors: Marwa Ahmed Aboelez, Abdallah Mohammed Ibrahim, Mohammed A ElSawy, Nermeen El sayed El-Khamisy
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Oral Health
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Online Access:https://doi.org/10.1186/s12903-025-05600-7
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author Marwa Ahmed Aboelez
Abdallah Mohammed Ibrahim
Mohammed A ElSawy
Nermeen El sayed El-Khamisy
author_facet Marwa Ahmed Aboelez
Abdallah Mohammed Ibrahim
Mohammed A ElSawy
Nermeen El sayed El-Khamisy
author_sort Marwa Ahmed Aboelez
collection DOAJ
description Abstract Background For more than 80% of patients with head and neck cancer, radiation therapy (RT) is a crucial component of their treatment plane which causes impairment for the masticatory apparatus functions leading to trismus. The study objective was to compare the efficacy of different treatment modalities for patients with RT-induced trismus on maximum mouth opening (MMO), visual analogue scale (VAS) (primary outcomes) patient satisfaction (secondary outcome). Methods Thirty-six patients with trismus after radiation therapy were classified equally and randomly into three groups (n = 12 per group): Group A was given threaded tapered screw appliance therapy (TTSA), Group B was given low-level laser therapy (LLLT), and Group C was given both threaded tapered screw appliance and low-level laser therapy (LLLT + TTSA). Maximum mouth opening (MMO), visual analogue scale (VAS) and Gothenburg Trismus Questionnaire (GTQ) scores and time required to achieve normal state were evaluated at baseline, 1, 2, 4 weeks, 3 and 6 months after the intervention. Data were collected and analysed using SPSS software. Results Regarding VAS and MMO, there was a statistically significant difference at different times of evaluation within all groups where (P <.0001). Regarding GTQ, group C recorded the least values for GTQ symptoms followed by group B followed by group A. Between groups A, B, and C at six months, there was a statistically significant difference for VAS. At three and six months, there was a statistically significant difference between all groups for MMO. At three and six months, there was a statistically significant difference between groups for all GTQ domains. Conclusion All available therapy modalities have the potential to effectively improve radiation induced trismus; however, the combination of TTSA and LLLT group appears to yield the most rapid and optimal enhancement. Clinical Trial Registry Number (NCT06413628) (05/12/2024) Retrospectively registered.
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spelling doaj-art-96d91e2c3ce040238d5c130ca66128842025-08-20T01:57:48ZengBMCBMC Oral Health1472-68312025-03-0125111210.1186/s12903-025-05600-7Efficiency of different treatment modalities on radiation induced trismus for maxillofacial cases: a parallel randomized clinical trialMarwa Ahmed Aboelez0Abdallah Mohammed Ibrahim1Mohammed A ElSawy2Nermeen El sayed El-Khamisy3Faculty of Dentistry, Department of Prosthodontics, Mansoura UniversityFaculty of Dentistry, Department of Prosthodontics, Mansoura UniversityDepartment of Prosthodontics, Menoufia UniversityFaculty of Dentistry, Department of Prosthodontics, Mansoura UniversityAbstract Background For more than 80% of patients with head and neck cancer, radiation therapy (RT) is a crucial component of their treatment plane which causes impairment for the masticatory apparatus functions leading to trismus. The study objective was to compare the efficacy of different treatment modalities for patients with RT-induced trismus on maximum mouth opening (MMO), visual analogue scale (VAS) (primary outcomes) patient satisfaction (secondary outcome). Methods Thirty-six patients with trismus after radiation therapy were classified equally and randomly into three groups (n = 12 per group): Group A was given threaded tapered screw appliance therapy (TTSA), Group B was given low-level laser therapy (LLLT), and Group C was given both threaded tapered screw appliance and low-level laser therapy (LLLT + TTSA). Maximum mouth opening (MMO), visual analogue scale (VAS) and Gothenburg Trismus Questionnaire (GTQ) scores and time required to achieve normal state were evaluated at baseline, 1, 2, 4 weeks, 3 and 6 months after the intervention. Data were collected and analysed using SPSS software. Results Regarding VAS and MMO, there was a statistically significant difference at different times of evaluation within all groups where (P <.0001). Regarding GTQ, group C recorded the least values for GTQ symptoms followed by group B followed by group A. Between groups A, B, and C at six months, there was a statistically significant difference for VAS. At three and six months, there was a statistically significant difference between all groups for MMO. At three and six months, there was a statistically significant difference between groups for all GTQ domains. Conclusion All available therapy modalities have the potential to effectively improve radiation induced trismus; however, the combination of TTSA and LLLT group appears to yield the most rapid and optimal enhancement. Clinical Trial Registry Number (NCT06413628) (05/12/2024) Retrospectively registered.https://doi.org/10.1186/s12903-025-05600-7Low-level laserRadiation therapyThreaded tapered screw applianceTrismus
spellingShingle Marwa Ahmed Aboelez
Abdallah Mohammed Ibrahim
Mohammed A ElSawy
Nermeen El sayed El-Khamisy
Efficiency of different treatment modalities on radiation induced trismus for maxillofacial cases: a parallel randomized clinical trial
BMC Oral Health
Low-level laser
Radiation therapy
Threaded tapered screw appliance
Trismus
title Efficiency of different treatment modalities on radiation induced trismus for maxillofacial cases: a parallel randomized clinical trial
title_full Efficiency of different treatment modalities on radiation induced trismus for maxillofacial cases: a parallel randomized clinical trial
title_fullStr Efficiency of different treatment modalities on radiation induced trismus for maxillofacial cases: a parallel randomized clinical trial
title_full_unstemmed Efficiency of different treatment modalities on radiation induced trismus for maxillofacial cases: a parallel randomized clinical trial
title_short Efficiency of different treatment modalities on radiation induced trismus for maxillofacial cases: a parallel randomized clinical trial
title_sort efficiency of different treatment modalities on radiation induced trismus for maxillofacial cases a parallel randomized clinical trial
topic Low-level laser
Radiation therapy
Threaded tapered screw appliance
Trismus
url https://doi.org/10.1186/s12903-025-05600-7
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