Postoperative TrismusNCT07575100
Maitland Mobilization Versus Therapeutic Ultrasound on Trismus Following Third Molar Surgery
A study testing Maitland Joint Mobilization and Therapeutic Ultrasound group in people with Postoperative Trismus, run by Cairo University at 1 site in Egypt.
Trial 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… Read more about this study
- Who is it for?
- Ages 20 to 30 years
- Conditions the study is for
- Postoperative Trismus
- What is being tested?
- Maitland Joint Mobilization and Therapeutic Ultrasound group
- Type of treatment
- Injection or infusion, Medical device, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 siteEgypt
- Study dates
- 10 May 2026to 25 Jul 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 20 to 30 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- 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
- All patients are medically and clinically stable when attending the study 2.1.2. Exclusion criteria:
- The study excluded the following patients:
Show all 13Show fewer
- 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
Who cannot join
None listed.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Effect of Maitland Mobilization Versus Therapeutic Ultrasound on Trismus Following Third Molar Surgery
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.
Read more
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.
Read the detailed description
This randomized clinical study will investigate the effect of Maitland mobilization compared to therapeutic ultrasound on trismus following third molar (wisdom tooth) surgery.
Trismus, characterized by limited mouth opening, is a common postoperative complication after third molar extraction and can affect oral function and quality of life All patients of both groups received Standard Postoperative Care designed to promote natural recovery after third molar surgery. The standard care protocol includes the use of Cold Compresses/Ice Packs, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), basic jaw exercises at home to prevent further restriction of jaw movement.
Group A Maitland Mobilization group: Participants received Maitland mobilization therapy. The manual therapy involved graded oscillatory movements targeting the temporomandibular joint (TMJ), aimed at improving jaw mobility and reducing pain following third molar surgery. Each therapy session lasted approximately 15-20 minutes and was conducted three times a week over a period of four weeks. During each session, the physiotherapist applied different grades of mobilization depending on the patient's progress. Grade I and II movements-small, rhythmic oscillations-were used initially to reduce pain and relax the muscles. As the treatment progressed, Grade III and IV mobilizations were applied to stretch the joint capsule and further improve range of motion. Additionally, patients were instructed to perform home exercises to maintain the therapeutic gains between sessions, such as gentle jaw stretching and mouth-opening exercises .
Group B (Therapeutic Ultrasound group): The procedure involved 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. Group C (Control group ): received traditional physical therapy program only. The outcomes measured included Maximum Interincisal Opening (MIO) via a Vernier Caliper. MIO was measured as the primary indicator of jaw mobility in patients experiencing postoperative trismus. MIO is the distance between the upper and lower central incisors when the patient opens their mouth fully, with the patient seated comfortably and properly supported. The MIO was recorded at baseline (before the intervention) and again at the end of the 4-week intervention period. Each measurement was repeated three times to ensure accuracy, with the average of the three readings used as the final recorded value. This process allows for consistent and precise tracking of improvements in jaw mobility over time.
- Conditions
- Postoperative Trismus
- Being tested
- Maitland Joint Mobilization, Therapeutic Ultrasound group, Control group
- Keywords
- Maitland technique, Ultrasound, trismus.
- Medical subject headings
- Trismus
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Maitland Joint MobilizationProcedure or surgery
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
Therapeutic Ultrasound groupDevice
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).
Control groupOther
the traditional physical therapy program (Standard Postoperative Care, Cold Compresses/Ice acks, NSAIDs);
| Study group | Role | What they receive |
|---|---|---|
| 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 Receives: 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 Receives: Device: Therapeutic Ultrasound group |
| Control group | Active comparator | traditional physical therapy program (Standard Postoperative Care, Cold Compresses/Ice Packs, NSAIDs); Receives: Other: Control group |
What is being measured
The primary outcome is the main question the study is designed to answer.
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)
Measured: Baseline, immediately post-intervention
Secondary outcomes (1)
Maximum Interincisal Opening
Maximum Interincisal Opening (MIO) via a digital caliper:
The maximum interincisal opening (MIO) measured as the primary indicator of jaw mobility in patients experiencing postoperative trismus. MIO is the distance between the upper and lower central incisors when the patient opens their mouth fully. The measurement taken using a digital caliper, with the patient seated comfortably and properly supported. The MIO will be recorded at baseline (before the intervention) and again at the end of the 4-week intervention period. Each measurement repeated three times to ensure accuracy, with the average of the three readings used as the final recorded value. This process allow for consistent and precise tracking of improvements in jaw mobility over time (Buesa-Bárez et al., 2018).
Measured: Baseline, immediately post-intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 May 2026
- Study start10 May 2026
- Primary completion10 Jul 2026 (estimated)
- Study completion25 Jul 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Postoperative TrismusStudies of the same condition, open and under way.
- More trials run by Cairo UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- 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
- Masking
- None (open label)
- Enrolment
- 60 participants (actual)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Rahma Ahmed Esmail, Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07575100
- Sponsor's protocol ID
- 000000
- Status last verified
- May 2026
- First submitted
- 3 May 2026
- Last updated
- 20 Jul 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 20 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Maitland Mobilization Versus Therapeutic Ultrasound on Trismus Following Third Molar Surgery
- ClinicalTrials.gov ID
- NCT07575100
- Acronym / sponsor ID
- 000000
- Conditions
- Postoperative Trismus
- Keywords
- Maitland technique, Ultrasound, trismus.
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 60 participants (actual)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 10 May 2026 (actual)
- Primary completion
- 10 Jul 2026 (estimated)
- Study completion
- 25 Jul 2026 (estimated)
- First posted
- 8 May 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Detailed description
This randomized clinical study will investigate the effect of Maitland mobilization compared to therapeutic ultrasound on trismus following third molar (wisdom tooth) surgery.
Trismus, characterized by limited mouth opening, is a common postoperative complication after third molar extraction and can affect oral function and quality of life All patients of both groups received Standard Postoperative Care designed to promote natural recovery after third molar surgery. The standard care protocol includes the use of Cold Compresses/Ice Packs, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), basic jaw exercises at home to prevent further restriction of jaw movement.
Group A Maitland Mobilization group: Participants received Maitland mobilization therapy. The manual therapy involved graded oscillatory movements targeting the temporomandibular joint (TMJ), aimed at improving jaw mobility and reducing pain following third molar surgery. Each therapy session lasted approximately 15-20 minutes and was conducted three times a week over a period of four weeks. During each session, the physiotherapist applied different grades of mobilization depending on the patient's progress. Grade I and II movements-small, rhythmic oscillations-were used initially to reduce pain and relax the muscles. As the treatment progressed, Grade III and IV mobilizations were applied to stretch the joint capsule and further improve range of motion. Additionally, patients were instructed to perform home exercises to maintain the therapeutic gains between sessions, such as gentle jaw stretching and mouth-opening exercises .
Group B (Therapeutic Ultrasound group): The procedure involved 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. Group C (Control group ): received traditional physical therapy program only. The outcomes measured included Maximum Interincisal Opening (MIO) via a Vernier Caliper. MIO was measured as the primary indicator of jaw mobility in patients experiencing postoperative trismus. MIO is the distance between the upper and lower central incisors when the patient opens their mouth fully, with the patient seated comfortably and properly supported. The MIO was recorded at baseline (before the intervention) and again at the end of the 4-week intervention period. Each measurement was repeated three times to ensure accuracy, with the average of the three readings used as the final recorded value. This process allows for consistent and precise tracking of improvements in jaw mobility over time.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
- Model description
- 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
| Arm | Type | Receives |
|---|---|---|
| Maitland Mobilization Group | Experimental | Procedure: Maitland Joint MobilizationParticipants 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 |
| Therapeutic Ultrasound group | Experimental | Device: Therapeutic Ultrasound groupParticipants 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 |
| Control group | Active comparator | Other: Control grouptraditional physical therapy program (Standard Postoperative Care, Cold Compresses/Ice Packs, NSAIDs); |
Who may qualify
- Ages
- 20 to 30 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (13 listed)
- Patients were included in this study have the following criteria
- 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.
Key exclusion criteria (0 listed)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Maitland Joint MobilizationMaitland 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 | Procedure or surgery | Maitland Mobilization Group |
| Therapeutic Ultrasound groupusing 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). | Device | Therapeutic Ultrasound group |
| Control groupthe traditional physical therapy program (Standard Postoperative Care, Cold Compresses/Ice acks, NSAIDs); | Other | Control group |
Primary outcome
Pain intensity level
Time frame: Baseline, immediately post-intervention
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)
1 secondary outcome
Maximum Interincisal Opening
Time frame: Baseline, immediately post-intervention
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 20 Jul 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Maitland Joint Mobilization and Therapeutic Ultrasound group in people with Postoperative Trismus, run by Cairo University at 1 site in Egypt.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 13 inclusion and 0 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 20 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Pain intensity level (time frame: Baseline, immediately post-intervention). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Jul 2026.