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The Efficacy of Appliance Therapy in Patients with Temporomandibular Disorders of Mainly Myogenous Origin. A Randomized, Controlled, Short-Term Trial

  • EwaCarin Ekberg1,*,
  • Danila Vallon1
  • Maria Nilner1

1Department of Stomatognathic Physiology, Faculty of Odontology, Malmö University, Malmö, Sweden

DOI: 10.11607/jofph.17133 Vol.17,Issue 2,June 2003 pp.133-139

Published: 30 June 2003

*Corresponding Author(s): EwaCarin Ekberg E-mail: ewacarin.ekberg@od.mah.se

Abstract

Aims: To compare the short-term efficacy of treatment with a sta-bilization appliance compared with that of a non-occlusal, control appliance in patients with temporomandibular disorders (TMD) of mainly myogenous origin. Methods: A randomized, controlled trial was performed with 60 patients suffering from myofascial pain. Patients were randomly assigned to a treatment or a control group. The treatment group was treated by means of a stabiliza-tion appliance and the control group by means of a non-occlusal appliance. Symptoms and signs were registered before and after 10 weeks of treatment. Results: Improvement of overall subjective symptoms was reported in both groups, but significantly more often in the treatment group than in the control group (P = .000). The prevalence of daily or constant pain showed a significant reduction in the treatment group (P = .028) compared with the control group. There was a significant decrease in the number of tender masticatory muscles in the treatment group (P = .018) com-pared with the control group. Conclusion: The results of this short-term evaluation suggest that the stabilization appliance is more effective in alleviating symptoms and signs in patients with TMD of mainly myogenous origin than a control, non-occlusal appliance. The stabilization appliance can therefore be recom-mended for the therapy of these patients.

Keywords

stabilization appliance; randomized controlled trial; temporomandibular disorders; myofascial pain

Cite and Share

EwaCarin Ekberg,Danila Vallon,Maria Nilner. The Efficacy of Appliance Therapy in Patients with Temporomandibular Disorders of Mainly Myogenous Origin. A Randomized, Controlled, Short-Term Trial. Journal of Oral & Facial Pain and Headache. 2003. 17(2);133-139.

References

1. Clark GT. A critical evaluation of orthopedic interocclusal appliance therapy: Design, theory and overall effectiveness. J Am Dent Assoc 1984;108:359–364.

2. Major PW, Nebbe B. Use and effectiveness of splint appliance therapy: Review of literature. Cranio 1997;15:159–166.

3. Marbach JJ, Raphael KG. Treatment of orofacial pain using evidence-based medicine: The case for intraoral appliances. In: Campbell JN (ed). Pain 1996; An updated review. Seattle: IASP Press, 1996:413–422.

4. Marbach JJ, Raphael KG. Future directions in the treat-ment of chronic musculoskeletal facial pain: The role of evidence-based care. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;83:170–176.

5. Forssell H, Kalso E, Koskela P, Vehmanen R, Puukka P, Alanen P. Occlusal treatments in temporomandibular disorders: Qualitative systematic review of randomized controlled trials. Pain 1999;83:549–560.

6. Rubinoff MS, Gross A, McCall WD. Conventional and nonoccluding splint therapy compared for patients with myofascial pain dysfunction syndrome. Gen Dent 1987;35:502–506.

7. Turk DC, Zaki HS, Rudy TE. Effects of intraoral appliance and biofeedback/stress management alone and in combination in treating pain and depression in patients with temporo-mandibular disorders. J Prosthet Dent 1993;70:158–164.

8. Dao TTT, Lavigne GJ, Charbonneau A, Feine JS, Lund JP. The efficacy of oral splints in the treatment of myofascial pain of the jaw muscles: A controlled clinical trial. Pain 1994;56:85–94.

9. Ekberg EC, Vallon D, Nilner M. Occlusal appliance therapy in patients with temporomandibular disorders. A double blind controlled study in a short-term perspective. Acta Odontol Scand 1998;56:122–128.

10. Dao TT, Lavigne GJ. Oral splints: The crutches for tem-poromandibular disorders and bruxism? Crit Rev Oral Biol Med 1998;9:345–361.

11. Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: Review, criteria, examinations and specifications, critique. J Craniomandib Disord 1992;6:301–355.

12. Scott J, Huskisson EC. Accuracy of subjective measurements made with or without previous scores: An important source of error in serial measurements of subjective states. Ann Rheum Dis 1979;38:558–559.

13. Huskisson EC. Visual analog scales. In: Melzack R (ed). Pain Measurement and Assessment. New York: Raven Press, 1983:33–37.

14. McNeill C (ed). Temporomandibular Disorders: Guidelines for Classification, Assessment and Management. Chicago: Quintessence, 1993:11–60.

15. Altman DG. Clinical trials. In: Altman DG (ed). Practical Statistics for Medical Research. London: Chapman & Hall, 1995:440–476.

16. Helkimo M. Studies on function and dysfunction of the masticatory system. II. Index for anamnestic and clinical dysfunction and occlusal state. Swed Dent J 1974;67:101–121.

17. Scholte AM, Steenks MH, Bosman F. Characteristics and treatment outcome of diagnostic subgroups of CMD patients: Retrospective study. Community Dent Oral Epidemiol 1993;21:215–220.

18. De Leeuw JRJ, Steenks MH, Ros WJG, Lobbezoo-Scholte AM, Bosman F, Winnubst JAM. Assessment of treatment outcome in patients with craniomandibular dysfunction. J Oral Rehabil 1994;21:655–666.

19. Greene CS, Olson RE, Laskin DM. Psychological factors in the etiology, progression, and treatment of MPD syndrome. J Am Dent Assoc 1982;105:443–448.

20. Eversole LR, Stone CE, Matheson D, Kaplan H. Psychometric profiles and facial pain. Oral Surg Oral Med Oral Pathol 1985;60:269–274.

21. Salter MW, Brooke RI, Merskey H. Temporomandibular pain and dysfunction syndrome: The relationship of clinical and psychological data to outcome. J Behav Med 1986;9:97–109.

22. Bush FM, Whitehill JM, Martelli MF. Pain assessment in temporomandibular disorders. J Craniomandib Pract 1989;7:137–143.

23. McCreary CP, Clark GT, Merril RL, Flack V, Oakley ME. Psychological distress and diagnostic subgroups of tem-poromandibular disorder patients. Pain 1991;44:29-34.

24. Dahlström L, Widmark G, Carlsson SG. Cognitive-behavioral profiles among different categories of orofacial pain patients: Diagnostic and treatment implications. Eur J Oral Sci 1997;105:377–383.

25. Davies SJ, Gray RJM. The pattern of splint usage in the management of two common temporomandibular disorders. Part II: The stabilization splint in the treatment of pain dysfunction syndrome. Br Dent J 1997;183:247–251.

26. Raphael KG, Marbach JJ. A year of chronic TMPDS: Evaluating patients’ pain patterns. J Am Dent Assoc 1992;123:53–58.

27. Laskin DM, Greene CS. Influence of the doctor-patient relationship on placebo therapy for patients with myofascial pain-dysfunction (MPD) syndrome. J Am Dent Assoc 1972;85:892–894.

28. Dworkin SF, LeResche L, Von Korff M, Dicker B, Sommers E. Constant, remitted and cyclic pain patterns in TMD: Three year follow-up [abstract 1399]. J Dent Res 1991;70:441.

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