Isences® TMD Physio Care™ – High-Resistance Jaw Mobility & Exercise Device for Rehabilitation

In TMJ physiotherapy, techniques such as joint distraction (e.g., thumb-on-molar) are commonly used to:

• Reduce intra-articular pressure
  
• Improve joint mobility
  
• Facilitate functional movement

TMD Physio Care™ can complement these techniques by:

• Providing controlled, sustained distraction-like forces
  
• Reducing therapist thumb and hand strain during repetitive sessions
  
• Delivering consistent and reproducible loading conditions

This improves treatment efficiency and supports the transition from manual therapy to active rehabilitation.

• Supports joint decompression and mobility (distraction-based therapy)
• Enables controlled, sustained resistance for therapeutic loading
• Reduces therapist thumb and hand strain during repetitive manual techniques
• Improves consistency and repeatability of applied forces
• Facilitates transition from passive techniques to active rehabilitation

This configuration is particularly suited for:

• Manual therapy support (e.g., joint distraction techniques)
  
• Early-stage or assisted mobilization
  
• Cases requiring joint unloading and controlled mandibular positioning
  
• Integration into structured TMJ physiotherapy protocols
  

It is intended for supervised clinical use, where precise control of force and movement is required.

TMD Physio Care™ (Higher-Resistance) is not a replacement for manual therapy, but a therapeutic extension tool that:

• Enhances treatment efficiency and therapist ergonomics
  
• Provides controlled mechanical assistance during therapy
  
• Supports progressive rehabilitation planning
  
• Bridges manual therapy and device-assisted intervention

• Withdrawing 20 ml of air from the device (using a syringe) allows insertion when the mouth opening is limited to  approximately 20 mm.
• Inflating with up to 19 ml of air enables the user to achieve a maximum mouth opening of approximately 36 mm.

(When used according to the recommended air volume , the device maintains effectiveness for more than 3K exercise cycles. Approximate measurements — actual results may vary with individual anatomy and clinical progress.)

Core Safety Principles

Pain-free rule

All exercises must remain within a comfortable, non-painful range. Mild stretching sensation is acceptable; pain is not.

Post-exercise response monitoring

No persistent pain, swelling, or stiffness should last beyond approximately 6 hours post-exercise.

If symptoms persist, reduce intensity, frequency, or discontinue use and reassess.

Movement quality

Prioritize slow, controlled, and symmetrical mandibular movement.

Avoid:

• Sudden or ballistic movements
  
• Clenching or excessive force
  
• Asymmetrical loading patterns
  
  
  Postural and Environmental Control

Posture

• Maintain upright, neutral head and cervical alignment
  
• Shoulders relaxed; avoid forward head posture
  
• No compensatory movements
  

Environment

• Perform exercises in a low-stimulation, calm setting
  
• Encourage relaxed breathing patterns
  

Minimize external factors that increase muscle tone (stress, distraction)

Progression and Load Management

• Progression must follow clinical reasoning and patient tolerance
  
• Increase:
  Air volume (resistance)
  Range of motion (opening amplitude)
  Exercise duration or repetitions
• only when pain-free adaptation is achieved

Transition from: mobility → controlled stability → functional strengthening

• Progression should be guided or supervised by a trained professional, especially in moderate to complex cases

⚠️ Contraindications and Precautions

Use only with clinical clearance in the following conditions

1. Acute or Active Conditions

• Acute inflammation of the TMJ
• Active locking episodes or acute trismus
• Active infection in the oral cavity or jaw (e.g., osteomyelitis, inflammatory joint conditions)

Post-Trauma or Post-Surgical Status

• Recent trauma to the mandible, maxilla, or TMJ
• Early post-operative phase without clinician clearance (e.g., orthognathic surgery, implant placement)
• Fixed or immobilized jaw (wired fixation)
• Recent dental implant procedures (resume only after healing and approval)

Systemic, Structural, or Neurological Conditions

• Malignancy in the orofacial or cervical region
• Severe osteoporosis or craniofacial bone fragility
• TMJ ankylosis (true bony fusion)
• Uncontrolled pain syndromes
• Neurological impairment affecting jaw control or sensation (e.g., trigeminal nerve dysfunction, motor control disorders)

Clinical Note

TMD Physio Care™ is intended for functional rehabilitation of the stomatognathic system.

Its use must be individualized based on diagnosis, functional limitation, and patient response, and integrated into a comprehensive rehabilitation plan where indicated.

Proper maintenance and cleaning are essential to ensure safe, hygienic, and long-term use of the  Jaw Device.

Cleaning After Each Use

• Release any remaining air from the functional element(s) via the syringe port.
• Rinse the device thoroughly under lukewarm running water to remove saliva.
•  Clean the exerciser with liquid soap and a soft cloth or brush, as needed.
• Rinse again with clean water to remove any detergent residues.

 Disinfection

• Wipe clean with a damp cloth or disinfectant wipe after each session.
• Allow the device to air-dry completely before storage or reuse.
• Do not autoclave or expose the device to high temperatures, as this may damage the material.

 Inspection and Maintenance

• Inspect the device before each use for cracks, leaks, or deformation.
• Check the air valve and tubing for secure sealing and smooth operation.
•  Replace the exerciser if you notice any signs of wear, air leaks, or tearing of the material.

  Storage

·         Store the Jaw Device clean and dry in a pouch sleeve and carrying case made of food-grade material.

The Jaw Device is made of biocompatible resin, which is designed for long-term skin contact (more than 30 days) and short-term mucosal contact (up to 24 hours), ensuring safety and great feel. The medical-grade resin, manufactured in an FDA registered, ISO 13485 certified factory and CE marked according to the EU MDR, meets the highest standards of quality and reliability.