Evaluation of Postural Exercises in the Treatment of Temporomandibular Disorders

• occlusal splint (Other): nineteen patients diagnosed with internal temporomandibular derangement will receive occlusal splint therapy, a treatment method with proven effectiveness.
• occlusal splints combined with rocabado exercise (Other): Nineteen patients diagnosed with internal temporomandibular derangement will be provided with Rocabado exercises in addition to the proven-effective treatment method of occlusal splint therapy. This approach aims to evaluate whether Rocabado exercises have a positive effect on the treatment process.
• occlusal splint combined with posture exercise (Other): Nineteen patients diagnosed with internal temporomandibular derangement will be provided with posture exercises in addition to the proven-effective treatment method of occlusal splint therapy. This approach aims to evaluate whether posture exercises have a positive effect on the treatment process.

Primary outcomes

• Investigation of the Effect of Postural Exercises and Rocabado Exercises on Pain Reduction [2 months]: Three different treatment protocols will be applied to patients with internal temporomandibular derangement, and the results obtained after a 2-month treatment period will be compared to determine which method is the most effective. To evaluate treatment outcomes, the patients' pre- and post-treatment Visual Analog Scale (VAS) scores will be assessed, with a decrease in the mean VAS score indicating a reduction in pain. Additionally, the pain threshold in various facial regions will be measured with an algometer before and after treatment to identify which treatment protocol is more effective in reducing pain. By combining both outcomes, the most effective method for pain reduction will be determined.
• Investigation of the Effect of Postural Exercises and Rocabado Exercises on Physiological Movements [2 months]: Changes in cervical range of motion (C-ROM) and the craniovertebral angle will also be evaluated to determine the impact of the treatment methods on these parameters. In this way, the method that is more effective in improving physiological movements will be identified.

Secondary outcomes

• Investigation of the Secondary Effects of Postural Exercises and Rocabado Exercises on Patient's Psychology [2 months]: The effect of the treatment protocols applied to the three different groups on the general psychology of the patients will be measured using the Hospital Anxiety and Depression Scale (HADS). In this test, a higher score indicates a higher level of depressive symptoms, and a successful treatment is expected to result in a decrease in the test score.
• Investigation of the Effect of Postural Exercises and Rocabado Exercises on the Mobility of the Neck and Jaw [2 month]: The patient's neck movements will be assessed, and the range of jaw movements will be evaluated. The study aims to identify which treatment protocol leads to the most significant improvement in jaw and neck mobility.

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Being diagnosed with internal temporomandibular disarrangement
* aged 18 years or older
* Willingness to participate in the study
* Ability to speak and understand Turkish, with no communication difficulties severe enough to impede understanding of the exercises

Exclusion Criteria:

* History of acute trauma in the TMJ or surrounding area
* TMJ dysfunction caused by a neurological condition
* History of surgical/invasive procedures or treatments on the TMJ
* Presence of infection or tumoral structures within intraoral structures
* History of tooth loss or use of dental prostheses
* History of surgical procedures in the cervical region

• Ebru K Mutlu, Clinical Prof., Study director, Bandırma Onyedi Eylül University