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Table 4 Active Physical Therapy instruction form for patients

From: Orthognathic surgery and temporomandibular joint symptoms

Instructions for active physical therapy (Yonsei Protocol)
It has been about 2 weeks after undergoing your jaw surgery. The purpose of this active physical therapy is to help your facial musculatures and jaws adapt into a new position from the surgery. Please follow the instructions in order to recover your original jaw movement and stable result.
1. Open your mouth as big as possible : Repeat 3 times
A. During the opening, check the lower incisal midline and do not allow laterally
B. deviated movement.
C. Close your mouth and lower tooth must be positioned into the splint without gap. If lower teeth are not positioned into the splint, try to close gap by pushing the jaw with your hands.
2. Move your lower jaw anteriorly : Repeat 3 times. From the original position, move your lower jaw anteriorly and move back to its original position. Check the midline of the lower teeth and do not allow laterally deviated movement.
3. Move your lower jaw to the left side : Repeat 3 times.
4. Move your lower jaw to the right side : Repeat 3 times.
5. Above instruction is 1 cycle. Please follow the instruction in order.
6. You have to repeat above physical therapy protocol for 1 hour.
7. Then, you have to fix the lower jaw to upper jaw for 2 hours.
8. During the physical therapy, training elastics must be kept in the instructed site.
9. Please avoid relatively hard food and be careful not to break the splint.
The splint is removed after 1 to 2 weeks of physical therapy, depending on the progess. It is not easy, but please be patient until finishing the physical therapy. This physical therapy is continued about 1 month and this therapy makes stable functional results.
Department of Oral & Maxillofacial Surgery Dental Hospital, Yonsei Medical Center
  1. Adopted from Jung HD, Jung YS, Park JH, Park HS. Recovery pattern of mandibular movement by active physical therapy after bilateral transoral vertical ramus osteotomy. J Oral Maxillofac Surg 2012;70:e431-7.