MAITLAND MOBILIZATION VERSUS THERAPEUTIC ULTRASOUND ON TRISMUS FOLLOWING THIRD MOLAR SURGERY

NCT07575100 | Completed DMC

• 1 other identifier: 000000
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to compare the effect of Maitland mobilization and therapeutic ultrasound on trismus (limited mouth opening) following third molar (wisdom tooth) surgery. Participants who experience limited mouth opening after third molar surgery will receive one of two treatment methods: Maitland joint mobilization or therapeutic ultrasound. These treatments are commonly used in physical therapy to improve jaw movement and reduce stiffness. The purpose of this study is to determine which treatment is more effective in improving mouth opening and reducing symptoms after surgery. Participation is voluntary, and all collected information will be kept confidential and used only for research purposes.

Conditions

Postoperative Trismus After Third Molar Extraction

Keywords

Maitland technique, Ultrasound, maximum mouth opening, trismus, third molar surgery.

Outcome Measures

Primary Outcomes (1)

• Pain intensity level

  Pain intensity level via The Visual Analog Scale (VAS): The VAS is self-completed by the participant. The participant is asked to place a line perpendicular to the VAS 100 mm line at the point that represents their pain intensity. The examiner reported the VAS score by measuring the distance (mm) from the marked point to the "no pain" anchor using a ruler, providing a range of scores from 0 -100 (Boonstra et al., 2008)

  Baseline, immediately post-intervention

Secondary Outcomes (1)

• Maximum Interincisal Opening

  Baseline, immediately post-intervention

Study Arms (3)

Maitland Mobilization Group

EXPERIMENTAL

Participants in this group received Maitland mobilization techniques applied to the temporomandibular joint. The intervention was performed by a trained therapist using graded passive mobilization techniques aimed at improving joint mobility and reducing trismus. Treatment sessions were conducted over the study period with standardized frequency and duration

Procedure: Maitland Joint Mobilization

Therapeutic Ultrasound group

EXPERIMENTAL

Participants received therapeutic ultrasound applied to the temporomandibular joint and surrounding muscles. The ultrasound was delivered at a frequency of 1 MHz to target deep tissues. Treatment sessions were conducted three times per week for four weeks, with each session lasting 10-15 minutes. A water-based conductive gel was applied to enhance transmission of sound waves. The intensity ranged from 0.8 to 1.5 W/cm² based on patient tolerance, and the transducer was moved in slow circular motions over the affected area to reduce pain and stiffness

Device: Therapeutic Ultrasound group

Control group

ACTIVE COMPARATOR

traditional physical therapy program (Standard Postoperative Care, Cold Compresses/Ice Packs, NSAIDs);

Other: Control group

Interventions

Maitland Joint Mobilization PROCEDURE

Maitland mobilization was applied to the temporomandibular joint using graded passive accessory and physiological joint mobilization techniques (Grade I-IV depending on patient tolerance). The technique was performed by a trained physical therapist to improve joint mobility and reduce trismus following third molar surgery. Treatment sessions were conducted three times per week for four weeks

Maitland Mobilization Group

Therapeutic Ultrasound group DEVICE

using an ultrasound device , such as the Chattanooga Intelect Mobile 2, which operates at a 1 MHz frequency to target deep tissues like the temporomandibular joint (TMJ) and surrounding muscles. The therapy was conducted three times a week for four weeks, with each session lasting 10-15 minutes. A water-based conductive gel was applied to the skin to facilitate effective transmission of sound waves, and the intensity of the ultrasound was adjusted between 0.8 to 1.5 W/cm² based on patient tolerance. The transducer was moved in slow, circular motions over the TMJ and affected muscles, focusing on areas of pain or stiffness (Bhushan et al., 2025).

Therapeutic Ultrasound group

Control group OTHER

the traditional physical therapy program (Standard Postoperative Care, Cold Compresses/Ice acks, NSAIDs);

Control group

Eligibility Criteria

• Age: 20 Years - 30 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Patients were included in this study have the following criteria
• Sixty patients had done third molar extraction surgery
• Patients suffering from postoperative trismus within 2 to 14 days post-surgery.
• Their age between 20 and 30 years old

You may not qualify if:

• The study excluded the following patients:
• Pre-existing TMJ Disorders: Patients with a history of temporomandibular joint (TMJ) disorders or jaw-related conditions (e.g., TMJ dislocation, arthritis, or previous TMJ surgery).
• Neurological or Muscular Disorders: (e.g., facial palsy, stroke, muscular dystrophy).
• Previous Jaw Surgery or Trauma.
• Use of Muscle Relaxants or other form of Physical Therapy treatment.
• Chronic Pain Syndromes: such as fibromyalgia or chronic migraines
• Infections or abscesses post-Surgery.
• Patients have auditory and visual problems

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Abu Hammad General Hospital

Abū Ḩammād, El-Sharqia Governorate, Egypt

Location

MeSH Terms

Conditions

Trismus

Interventions

Control Groups

Condition Hierarchy (Ancestors)

Spasm; Neuromuscular Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Epidemiologic Research Design; Epidemiologic Methods; Investigative Techniques; Research Design; Methods

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: This study was conducted as an open-label trial. No masking was applied, and both participants and investigators were aware of the assigned interventions in all study arms
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Physical Therapist (MSc Candidate)

Model Details: This study used a parallel assignment design. Participants diagnosed with trismus following third molar surgery were randomly allocated into three independent groups: Maitland mobilization group, therapeutic ultrasound group, and a control group. Each intervention group received its assigned treatment separately during the study period

Study Record Dates

• First Submitted: May 3, 2026
• First Posted: May 8, 2026
• Study Start: October 10, 2025
• Primary Completion: February 20, 2026
• Study Completion: March 10, 2026
• Last Updated: May 8, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)