40134 - NEW PERSPECTIVES IN APPROACHING THE PHYSIOTHERAPY OF CRANIO-MANDIBULAR DYSFUNCTIONS

Subject type: Optional

Coordinator: Marc Terradellas Fernández

Trimester: Third term

Credits: 4

Academic year: 2025

Teaching course: 4

• Catalan

In order to be able to take this subject, there are no prerequisites related to passing other subjects in the study plan.

Craniomandibular disorders have a very high prevalence in the general population with a maximum incidence in adolescence and in adults, especially related to the female sex (the ratio of affect is approximately four women for every man). These disorders can include disorders related to the temporomandibular joints, the muscles of the masticatory system or nearby areas such as the cervical region and the skull itself. The symptoms are very diverse and may refer to joint pain, joint noises during jaw function, alterations of jaw dynamics or limitations of oral mobility; tensional pain in the muscle areas of the masticatory system, mobility disturbances and cervical myofascial pain and other disturbances referring to the ears (otalgia, tinnitus, etc.) and the skull in the form of headaches and orofacial pain.

A multidisciplinary approach is essential to properly treat these disorders and, therefore, collaboration between dentists, physiotherapists, psychologists and maxillofacial doctors is essential. The role of physiotherapy is basic and requires anatomical and joint biomechanical knowledge in order to apply a correct functional assessment. The treatment techniques are very varied: specific joint mobilizations, anti-pain electrotherapy techniques, application of myofascial procedures, indication of therapeutic exercise and even the application of invasive techniques such as dry needling.

The aim of this subject will be to broadly introduce students to this area of ​​knowledge so that they can acquire the necessary knowledge and procedural skills to be able to evaluate this type of disorder and to be able to come up with an appropriate approach in the design of the therapeutic intervention from the point of view of physiotherapy.

The distribution of the theoretical and/or practical content of the subject can be consulted in the schedule and sections of the corresponding virtual classroom before it starts.   

This subject aims to introduce the gender perspective in its content and development. In addition, the objectives are aligned with the Sustainable Development Goals (SDGs) of the 2030 Agenda of the United Nations. 

The classroom (physical or virtual) is a safe space, free of sexist, racist, homophobic, transphobic and discriminatory attitudes, either towards students or towards teachers. We trust that together we can create a safe space where we can make mistakes and learn without having to suffer prejudice from others.  

Topic 1. Temporomandibular anatomy and biomechanics:

• Articular bone surfaces
• articular disc
• Capsular and ligamentous containment elements.
• Vascularization and joint innervation
• Masticatory muscles
• Physiology of joint movement

Topic 2. Craniomandibular dysfunction:

• Concept and epidemiology
• Classification of clinical articular entities
• Classification of myofascial clinical entities masticatory system

Topic 3. Clinical examination:

• Assessment of joint pain
• Assessment and registration of mandibular movements
• Joint scan
• Myofascial exploration masticatory system

Topic 4. Physiotherapy in craniomandibular disorders:

• Manual joint mobilization techniques
• Physical agents in the treatment of pain
• Myofascial treatment techniques

Topic 5. Complementary diagnostic tests:

• NMR.
• Computerized axial tomography
• Radiological tests

Topic 6. Craniomandibular dysfunction and cervical region:

• Functional relationships between the cervical area and the masticatory system
• Craniomandibular dysfunction and posture

This subject may consider the following indicators detailed in the table in the evaluation proposal:

A system of quantitative (from 0 to 10) and qualitative (suspended, approved, notable, excellent, honorary registration) is used according to RD 1125/2003.  

The subjects will have evaluation and recovery activities in accordance with the teaching guide and the subject's learning plan, published in their virtual classroom and which will establish the necessary requirements to be able to participate.  

In accordance with current UPF regulations, all students who, having participated in the learning and assessment activities during the term, have obtained a failing grade for the corresponding subject in the quarterly assessment may participate in the recovery process . Those who have not participated in the learning and assessment activities or who have waived the assessment will not be able to participate. If the grade is "not submitted", you will not be able to opt for recovery and therefore the subject will have to be taken again in its entirety in the following academic year. 

Assistance and Rules of Conduct

Attending class without respecting the basic rules of hygiene and uniform dress may be sanctioned. During the practices in class and especially during the assessment tests, students may not wear objects that could interfere with the execution of the techniques, such as rings, watches, bracelets, long earrings, etc. Likewise, hand hygiene will be essential, with short, clean, unpainted nails. Given the practical nature of the classes and in order to facilitate and correctly perform the manual palpation procedures and the execution of the evaluation tests, it will be necessary to wear appropriate clothing such as shorts and a top, considering that in many situations the anatomical region evaluated must be stripped of clothing to be able to observe and palpate the anatomical reliefs.

It will be essential to comply with an attendance of no less than 80% of the hours in order to pass the subject. In case of non-compliance with this rule, the subject will be suspended and will have to be re-enrolled in the following academic year.

Any form of academic fraud will be sanctioned in accordance with the school's assessment regulations. If signs of fraud are detected, including the improper use of generative artificial intelligence tools, the subject's teaching staff may
call the student for an individual interview with the aim of verifying their authorship. The use of artificial intelligence (AI) in this subject is regulated in the Learning Plan. It must be consulted to find out the specific conditions of use.