Isences® TMD Physio Care™ – Low-Resistance Jaw Mobility & Exercise Device for Home and Rehabilitation Support

TMD Physio Care™ combines within one adaptable system:

• Gentle joint-friendly mobilization
  
• Muscle relaxation and tension reduction
  
• Low-intensity functional strengthening
  

This allows to apply a structured and progressive TMJ rehabilitation strategy, tailored to the patient’s tolerance and stage of recovery.

The low-resistance configuration is suitable for integration into physiotherapy protocols addressing:

• Early-stage mobility restriction
  
• Post-surgical or post-traumatic rehabilitation (following clinical clearance)
  
• Bruxism-related muscle tension and guarding
  

It provides a consistent, controlled, and patient-tolerant approach to restoring jaw function.

Designed for clinical environments, the device can be incorporated into:

In-clinic treatment:

• Assisted mobility and gentle joint unloading
  
• Early neuromuscular re-education
  

Home exercise programs:

• Daily mobility exercises
  
• Reinforcement of clinical outcomes
  
• Improved adherence and continuity of care

The device is designed to enable insertion and controlled expansion in patients with restricted mandibular opening.

• Reduced-volume insertion:
  Withdrawing approximately 10 ml of air allows insertion at a minimal interincisal opening of ~15 mm
  
• Progressive expansion range:
  Controlled inflation up to ~ max. 14 ml of air supports gradual increase in mouth opening up to ~32 mm

Performance Note
When used within recommended parameters, the device maintains functional integrity for >3000 exercise cycles

Values are approximate and dependent on individual anatomy and clinical progression

The device provides low-load, controlled mechanical stimulus suitable for early-phase rehabilitation.

Mandibular Movement Amplitude
Supports controlled jaw-opening exercises up to ~17 mm functional amplitude
→ Facilitates safe, guided range-of-motion training

Stretching Force - Mobility Training
Generates up to ~18 N of low-load stretching force

→ Supports viscoelastic tissue adaptation
→ Promotes reduction of muscle guarding and stiffness

Strengthening Force - Stability Training
Provides resistance up to ~22 N, depending on:

• Air volume
• Bite amplitude

→ Enables submaximal isometric loading
→ Supports neuromuscular activation and coordination

Load Modulation
Resistance is dynamically adjustable via:

• Air volume (primary variable)
• Occlusal compression range (secondary variable)

→ Allows precise clinical dosing of load and intensity

Performance Note
Maintains functional consistency for >3000 cycles when used within recommended air volume and loading parameters

The device provides a controlled mechanical environment that supports key rehabilitation mechanisms:

• Low-load, sustained stretching

→ promotes viscoelastic adaptation of soft tissues
→ reduces muscle hyperactivity and stiffness

• Adjustable submaximal resistance

→ facilitates neuromuscular activation and coordination
→ supports early-stage strengthening without joint overload

• Guided shear–rotational mandibular movement
  

→ aligns with physiological TMJ kinematics
→ helps minimize non-physiological loading patterns

The Low-Resistance Jaw Device is optimally positioned within:

Phase 1 — Mobility Restoration

• Improve range of motion
• Reduce guarding and pain-related limitation
  

Phase 2 — Early Neuromuscular Control

• Introduce controlled activation
• Establish symmetrical, coordinated movement patterns

Role in Rehabilitation Pathway

• Entry-level device for structured TMD rehabilitation
• Provides a foundation for progression toward higher resistance training
• Facilitates transition from passive mobility → active control

• Ergonomic intraoral design for secure and comfortable positioning
• Enables safe, repeatable application
• Adaptable resistance based on therapeutic needs
• Suitable for both supervised and guided self-use

Core Safety Principles

Pain-free rule

• All exercises must remain within a comfortable, non-painful range.
• A mild stretching sensation is acceptable—pain is not.

Post-Exercise Response Monitoring

After each session, monitor the response:

• No persistent pain, swelling, or stiffness should last beyond few minutes
  If symptoms persist:
  
  → Reduce intensity or frequency
  
  → Pause use and reassess if needed
  

Movement Quality
Prioritize slow, controlled, and symmetrical mandibular movement.

Avoid:

• Sudden or forceful (ballistic) movements
• Clenching or excessive force

Progression & Load Management
Progression should follow clinical reasoning and patient tolerance.

Increase gradually:

• Air volume (resistance)
• Range of motion (jaw opening)
• Exercise duration or repetitions
  
  Only progress when pain-free adaptation is achieved
  

Uncontrolled or unintended asymmetrical loading

⚠️ 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.